Jay Pan

• Ph.D.
• Professor at Sichuan University

Objectives Community pharmacies play a crucial role in China’s primary health care system. This study aimed to assess the impact of stringent COVID-19 policy responses - such as lockdowns, travel restrictions and operational closures - on unannounced standardized patients’ (USPs) satisfaction with community pharmacy services. Methods A cross-secti...

To comprehensively assess regional landslide hazards, we propose a geospatial approach that jointly evaluates both the probability of occurrence (susceptibility) and potential destructive power (intensity) within a single framework, overcoming the limitations of previous studies that treated these two disaster scenarios independently. Focusing on t...

Purpose Ambulatory Care Sensitive Conditions (ACSCs) refer to hospital encounters that could potentially be prevented with improved primary care. Chronic Obstructive Pulmonary Disease (COPD) as one of the typical ACSCs, and its hospitalization is considered potentially preventable through the quality primary care. However, the literature on factors...

Background While stationary links between childhood hand, foot and mouth disease (HFMD) and air pollution are known, a comprehensive study on their heterogeneous relationships (nonstationarity), jointly considering numerical, temporal and spatial dimensions, has not been reported. Methods Monthly HFMD incidence and air pollution data were collecte...

Background An increasing number of orphan medicinal products (OMPs) are being included in social health insurance schemes, significantly improving access to medicines for patients with rare diseases. However, high-priced OMPs are still not covered, primarily due to health equity controversies and inadequate data systems required for economic evalua...

Globally, poverty and illness are linked, attracting widespread attention. In China, illness contributes to about 40% of rural poverty. This study sought to investigate how healthcare-seeking behavior differs between impoverished and non-impoverished populations within the same Chinese healthcare delivery system. It also sought to understand how di...

Background Maternal and perinatal health are fundamental to human development. However, in low-resource settings such as sub-Saharan Africa (SSA), significant challenges persist in reducing maternal, newborn, and child mortality. To achieve the targets of the sustainable development goal 3 (SDG3) and universal health coverage (UHC), improving acces...

Background Different kinds of mobile apps are used to promote communications between patients and doctors. Studies have investigated patients’ mobile app adoption behavior; however, they offer limited insights into doctors’ personal preferences among a variety of choices of mobile apps. Objective This study aimed to investigate the nuanced adoptio...

Background: Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is an efficient method that can reduce lung cancer mortality in high-risk individuals. However, few studies have attempted to measure the preferences for LDCT LCS service delivery. This study aimed to generate quantitative information on the Chinese population’s prefer...

Background High prices of anticancer drugs have raised concerns due to their financial impact on patients and healthcare systems. This study aimed to assess the initial and latest list prices and clinical value of reimbursed anticancer drugs in China, Japan, and South Korea. Methods We identified anticancer drugs newly approved by the National Med...

Aims This study aimed to investigate how clinical pathway implementation satisfaction, work engagement, and hospital–patient relationship impact the quality of care that is provided by nurses in public hospitals. Background Clinical pathways are recommended as a form of quality improvement by broader healthcare systems and are widely used in the w...

Background Many countries has introduced pro-competition policies in the delivery of healthcare to improve medical quality, including China. With the increasing intensity of competition in China's healthcare market, there are rising concerns among policymakers about the impact of hospital competition on quality. This study investigated heterogeneou...

Background The hospitalization rate of ambulatory care sensitive conditions (ACSCs) has been recognized as an essential indicator reflective of the overall performance of healthcare system. At present, ACSCs has been widely used in practice and research to evaluate health service quality and efficiency worldwide. The definition of ACSCs varies acro...

Background: To investigate the association of launch price and clinical value with reimbursement decisions for anticancer drugs after the implementation of reimbursement-linked price negotiation in China. Methods: Anticancer drugs approved by the NMPA of China from January 2017 to June 2022 were eligible for inclusion. Approval and reimbursement da...

Background The job performance of clinicians is a clear indicator of both hospital capacity and the level of hospital service. It plays a crucial role in maintaining the effectiveness and quality of medical care. Clinical pathways are a systematic method of quality improvement successfully recommended by broader healthcare systems. Since clinicians...

Background Regular Low-Dose Computed Tomography (LDCT) for lung cancer high-risk population has been proved to improve health outcomes and relieve disease burden efficiently for both individual and society. With geographical impedance becoming the major barrier preventing patients from getting timely healthcare service, this study incorporated heal...

Limited evidence exists regarding the causal effects of air pollution and metabolic syndrome (MetS), as well as the potential moderating effect of adherence to healthy dietary patterns. We recruited participants with accessible clinical characteristics, dietary patterns, and blood biomarkers data from the 2009 China Health and Nutrition Survey. Mul...

Background Ensuring universal health coverage and equitable access to health services requires a comprehensive understanding of spatiotemporal heterogeneity in healthcare resources, especially in small areas. The absence of a structured spatiotemporal evaluation framework in existing studies inspired us to propose a conceptual framework encompassin...

Dramatic geographic variations in healthcare expenditures were documented by developed countries, but little is known about such variations under China’s context, and what causes such variations. This study aims to examine variations of healthcare expenditures among small areas and to determine the associations between demand-, supply-factors, and...

疾病控制优先（disease control priority, DCP）是一种重要的公共健康干预策略。该策略首先依据疾病负担严重程度、疾病防治技术有效性、现有卫生系统的防治能力等一系列标准筛选出应作为优先防控的疾病，然后就这些疾病的防控技术展开定性（如面对面访谈、专家咨询、研讨会等）和定量（如成本效益分析、多准则决策分析等）评估，最终确定应作为优先推进的公共卫生举措。从理念的产生，到概念的正式提出，再到实践的指导，DCP历经70多年，为提高发展中国家医疗卫生服务体系效率，促进人群健康做出了重要贡献。本研究系统梳理DCP产生背景、发展历程、实现方法和实践应用，旨在探讨DCP在卫生治理中的应用潜能，为全面推进健康中国建设提供技术支撑和决策参考。

Background While China has implemented reimbursement-linked drug price negotiation annually since 2017, emphasizing value-based pricing to achieve a value-based strategic purchase of medical insurance, whether drug prices became better aligned with clinical value after price negotiation has not been sufficiently established. This study aimed to ass...

Over the past 2 decades, China has made remarkable progress in health-care service coverage, especially in the areas of reproductive, maternal, newborn, and child health, infectious diseases, and service capacity and access. In these areas, coverage is comparable to those in high-income countries. Inequalities of service coverage in these areas hav...

This report analyses the underlying causes of China's achievements and gaps in universal health coverage over the past 2 decades and proposes policy recommendations for advancing universal health coverage by 2030. Although strong political commitment and targeted financial investment have produced positive outcomes in reproductive, maternal, newbor...

Scholarly attention has been dedicated to the identification of low-value care (care that is not expected to provide a net benefit). Despite a consensus on the importance of hospital characteristics in explaining the use of low-value care, the precise influence of hospital ownership, herein the distinction between public and private ownership, rema...

Background The hospitalization rate of ambulatory care sensitive conditions (ACSCs) has been recognized as an essential indicator reflective of the overall performance of healthcare system. At present, ACSCs has been widely used in practice and research to evaluate health service quality and efficiency worldwide. The definition of ACSCs varies acro...

Background Healthy China is a nationwide health strategy aiming at improving health from diverse dimensions, and strengthening high-quality assessment is essential for its stimulation. However, there is limited evidence in the surveillance of the actual performance of the initiative at regional levels. This study innovatively proposes a two-step su...

Background: Community pharmacy services play a crucial role in China's primary healthcare system. However, the COVID-19 pandemic has introduced unprecedented challenges. Assessing the impact of COVID-19 closure policies on patient satisfaction and evaluating the underlying mechanisms are essential for enhancing the quality of pharmacy services. Met...

Chinese health system remains the crucial one for understanding the wider healthcare landscape across the Global South and in particular the leading Emerging Markets. Purpose of our observation was to understand the inner dynamics of mainland Chinese health reforms adopting a lengthy time horizon. We have analysed the public reports and seminal evi...

Background Plenty of efforts have been made to reduce the use of low-value care (the care that is not expected to provide net benefits for patients) across the world, but measures of low-value care have not been developed in China. This study aims to develop hospital discharge records-based measures of low-value surgical procedures, evaluate their...

BACKGROUND Maternal and perinatal health are fundamental to human development. However, in low-resource settings such as sub-Saharan Africa (SSA), significant challenges persist in reducing maternal, newborn, and child mortality. To achieve the targets of the sustainable development goal 3 (SDG3) and universal health coverage (UHC), improving acces...

BACKGROUND Different kinds of mobile apps are used to promote communications between patients and doctors. Studies have investigated patients’ mobile app adoption behavior; however, they offer limited insights into doctors’ personal preferences among a variety of choices of mobile apps. OBJECTIVE This study aimed to investigate the nuanced adoptio...

Nurses play a pivotal role in the delivery of medical services. Professional commitment is crucial for nursing professionals’ long-term, healthy, and sustainable development. However, nursing students’ professional commitment levels are currently unsatisfactory in China, especially given that the COVID-19 pandemic has posed unprecedented challenges...

Few studies have examined the causal relationship between chronic exposure to air pollutants during pregnancy and depression in adolescent offspring. In addition, it has not been investigated whether exposure is most harmful to adolescents in certain populations and at certain stages of pregnancy. A total of 1975 adolescents from 1632 families from...

Objective This study aimed to examine the clinical capability of township healthcare centres (THCs), the main primary care providers in rural China, as a basis for rural health service planning. Design Observational study of quantitative analysis using administrative data. Setting Three counties with low, middle and high social economic developme...

Background There is little evidence on whether PM2.5 and ground surface ozone have consistent effects on increased individual medical costs, and there is a lack of evidence on causality in developing countries. Methods This study utilized balanced panel data from 2014, 2016, and 2018 waves of the Chinese Family Panel Study. The Tobit model was dev...

Maternal and perinatal healthcare remain insufficient in impoverished regions such as sub-Saharan Africa (SSA), and removing geographic barriers to access continuous maternal and perinatal healthcare services (CMPHS) has been addressed as a critical strategy. Based on the framework of maternal, neonatal, and child health (MNCH) proposed by WHO, acc...

Objective: To evaluate the effect of Health Poverty Alleviation Project on the economic burden of disease among poor families and to provide references for further improvement of the Health Poverty Alleviation Project. Methods: The difference-in-differences with propensity score matching method was used to analyze 48 counties in Sichuan Province...

Background: Private hospitals expanded rapidly in China since 2009 following its national health reform encouraging private investment in the hospital sector. Despite long-standing debates over the performance of different types of hospitals, empirical evidence under the context of developing countries remains scant. We investigated the disparitie...

Background There is little evidence on the association between PM2.5 chemical components and fatality among hospitalized stroke patients. Methods This study used an inpatient discharge database from 2013 to 2019 in four provinces (Sichuan, Shanxi, Guangxi, and Guangdong) in China. Annual average exposure to PM2.5 and its five chemical components [...

Population demand, healthcare resourcing, and transportation linkage are considered as major determinants of spatial access to health care. Temporal changes of the 3 determinants would result in gain or loss of spatial access to health care. As a remarkable milestone achieved by Targeted Poverty Reduction Project launched in China, the significant...

Long-term exposure to air pollutants is likely to be associated with mental disorders, but relevant studies remain limited and inconsistent, and evidence to assess causality is particularly lacking, especially in developing countries. In addition, there are few studies on the role of physical activity in this relationship. We investigated the causa...

In recent years, there is growing evidence that long-term exposure to fine particulate matter (PM2.5) is associated with depressive symptoms. However, little is known about the individual effects of PM2.5 components, particularly in low-income and middle-income countries. We investigated the association between long-term exposure to major component...

Background To estimate the associations between ambient particulate matter (PM) pollution of different sizes (PM1, PM2.5, and PM10) and risk of rehospitalization among stroke patients, as well as the attributable burden in China. Methods We built a cohort of 1,066,752 participants with an index stroke hospitalization in Sichuan, China from 2017 to...

Background In China, in addition to cost-related reasons, most high-priced orphan medicinal products (OMPs) remain excluded from the coverage of the social health insurance program due to the lack of reimbursement budget via economic evaluation approaches. Purpose To estimate the budget of high-priced OMPs for life-threatening rare diseases (RDs)...

Supplementary 1. Descriptive statistics, normality, and multicollinearity test for sixteen variables. Supplementary 2. Bayesian model evaluation. Supplementary 3. Country subgroups with various ageing processes. Supplementary References.

Global concerted and sustained action is required under a rapid population ageing trend, while global ageing varies across countries in space and time. To support global action on sustainable development and healthy ageing, we investigated the spatiotemporal heterogeneity toward associations between national population ageing (the share of the popu...

Background: Although studies have provided the estimates of floods-diarrhoea associations, little is known about the lag effect, effect modification, and attributable risk. Based on Sichuan, China, an uneven socio-economic development province with plateau, basin, and mountain terrains spanning different climatic zones, we aimed to systematically...

SUPPLEMENTARY MATERIAL. ARTICLE: Spatiotemporal disparities in regional public risk perception of COVID-19 using Bayesian Spatiotemporally Varying Coefficients (STVC) series models across Chinese cities. JOURNAL: International Journal of Disaster Risk Reduction. CONTENTS: Supplementary Note 1. Principal component analysis for COVID-19 regional pu...

Introduction Travel burden is a key dimension in conceptualizing geographic access to health care. Travel time measured from the perspective of actual utilization provides practical evidence on healthcare-related travel burden, while studies in this aspect remain limited, especially under the context of China's healthcare system. This study aimed t...

Objective To characterize the association of ambient particulate matter (PM) pollution of different sizes (particulate matter ≤1 µm in aerodynamic diameter [PM 1 ], PM 2.5 , and PM 10 ) with in-hospital case fatality among stroke patients in China. Methods We collected hospitalizations due to stroke in four provinces in China from 2013 to 2019. Se...

Health care in China suffers from substantial allocative inefficiency in the delivery system and technical inefficiency within hospitals. To ameliorate this problem in rural areas, the Analysis of Provider Payment Reforms on Advancing China's Health (APPROACH) project shifted the payment method of China's rural health insurance scheme for county ho...

Objective: Findings regarding the association between delivery volume and maternal health outcomes are mixed, most of which explored their correlation. This study aims to demonstrate the causal effect of delivery volume on severe maternal morbidity (SMM) in China. Methods: We analysed all women giving birth in the densely populated Sichuan provi...

Background Prior research has suggested that functional disability was associated with increased risk of incident depressive symptoms in the elderly. However, little is known about the potential role of functional disability on the long-term trajectories of depressive symptoms among middle-aged and older Chinese adults. Methods Data were drawn fro...

Regional public attention has been critical during the COVID-19 pandemic, impacting the effectiveness of sub-national non-pharmaceutical interventions. While studies have focused on public attention at the national level, sub-national public attention has not been well investigated. Understanding sub-national public attention can aid local governme...

Objectives Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old. Method...

We analyzed COVID-19 influences on the design, implementation, and validity of assessing the quality of primary health care using unannounced standardized patients (USPs) in China. Because of the pandemic, we crowdsourced our funding, removed tuberculosis from the USP case roster, adjusted common cold and asthma cases, used hybrid online–offline tr...

We aimed to explore the association between the number of primary healthcare workers and infectious diarrhea morbidity at community levels and to provide evidence-based implications for optimizing primary healthcare manpower resource allocations. We collected annual infectious diarrhea morbidity and relevant data of 4321 communities in Sichuan Prov...

Potentially avoidable hospitalizations are associated with high and rising costs, and they have been widely considered as important performance indicators of the healthcare system, particularly in primary care. This study explored the relationship between spatial access to primary care and potentially avoidable hospitalizations of the elderly based...

Background Healthcare resources are always more limited compared with demand, but better matching supply with demand can improve overall resource efficiency. In countries like China where patients are free to choose healthcare facilities, over-utilization and under-utilization of healthcare resources co-exist because of unreasonable healthcare seek...

Objectives To delineate hospital service areas (HSAs) using the Dartmouth approach in China and identify the hypothesised demand-side, supply-side and region-specific factors of health expenditure within HSAs. Design Population-based descriptive study. Setting We selected the metropolis of Chengdu, one of the three most populous cities in China a...

Background We aimed to prospectively evaluate the associations between the baseline and changes in high-density C-reactive protein (hs-CRP) and incident metabolic syndrome (MetS) in China and update the evidence based on a meta-analysis of cohort studies in different populations. Methods Data from the China Health and Retirement Longitudinal Study...

Background Multiple pro-competition policies were implemented during the new round of healthcare reform in China. Differences in conditions’ complexity and urgency across diseases associating with various degrees of information asymmetry and choice autonomy in the process of care provision, would lead to heterogeneous effects of competition on heal...

Background Provider payment system has a profound impact on health system performance. In 2016, a number of counties in rural Guizhou, China, implemented global budget (GB) for county hospitals with quality control measures. The aim of this study is to measure the impact of GB combined with pay-for-performance on the quality of care of inpatients i...

Medical service pricing reform was considered as one of the focuses of China's remarkable health reform. This paper preliminarily assessed the roles of medical service pricing in the context of China's healthcare system. Specifically, we described the potential roles of medical service pricing in China and pointed out relevant challenges that emerg...

The outbreak of coronavirus disease 2019 (COVID-19) has led to numerous tragic deaths all over the world. Great efforts have been made by worldwide nations for COVID-19 targeted vaccine development since the disease outbreak. In January 2021, the Chinese government started to provide free vaccination among nationwide communities, which was optional...

Hospital infrastructure has been addressed as the prerequisite of healthcare delivery which intensively affects medical quality. Over the past decade, China has proposed a series of investment plans for hospital infrastructure in order to promote healthcare development in underdeveloped regions. Focusing on the construction of hospital buildings as...

Background: This study was conducted for assessing the degrees of perceived competition reported by county hospital directors in rural China as well as hospitals' competitive behaviors in response to competition. Methods: The data were collected from Analysis of Provider Payment Reforms on Advancing China's Health (APPROACH) project which had be...

With the implementation of a series of pro-competition policies in China, the hospital market competition has been intensified dramatically over the past decade. Based on previous literature, such competition is very much likely to bring about an upgoing trend in the promotion and expansion of medical facilities among hospitals as an essential stra...

Objective: This study aims to provide empirical evidence for the controversy about whether the inference is consistent if alternative hospital market definition methods are employed, and for which definition method is the best alternative to the predicted patient flow approach. Data sources: Collecting data from the discharge data of inpatients and...

The evidence about the role of hospital market competition on health technology diffusion in developing countries is scarce. In this study, we examined the association between hospital market competition and the diffusion of health technologies in China's healthcare system. Laparoscopic appendectomy, a minimally invasive surgery for patients with a...

Background Depression has been shown in some studies to be associated with knee pain. Females were widely recognized as more vulnerable to depression and knee pain than males. However, the role of sex in this correlation was under-researched. This study aimed to investigate the association between depressive symptoms and subsequent knee pain, as we...

Background Underutilization of health services among chronic non-communicable disease sufferers, especially for hypertension (HBP) and diabetes mellitus (DM), was considered as a significant contributing factor to substantial cases in terms of both avoidable morbidity and mortality. However, evidence on health services underutilization and its asso...

The reduction of diabetes‐related avoidable hospitalisations (AHs) can be achieved via the provision of timely and effective primary healthcare (PHC), which has made diabetes AHs rate a widely adopted indicator for evaluating the performances of PHC systems. This study reported the AHs rate of diabetes and further explored its relationship with PHC...

Background: Over the past 5 years, China has invested substantially in palliative care programs to meet the rising demand for such services. In China's mainland, most palliative care programs are embedded within an established hospital unit, but a small subset of providers practice exclusively in a stand-alone inpatient palliative care department....

Objective Pyrethroids-containing products are widely used as commercial and household insecticides. While animal studies and clinical case reports have shown acute cardiovascular outcomes of pyrethroids exposure, little has been known on the effect of chronic pyrethroid exposure on cardiovascular disease (CVD). We aimed to examine the associations...

The inequity in spatial access to health care among regions remains one of the most persistent challenges faced by countries around the world. This study addressed the problem of maldistribution of top-tier healthcare resources in China via the adoption of rational health planning. We proposed an optimization model to maximize the equity in spatial...

Purpose: Rational location of emergency medical service (EMS) facilities could improve access to EMS, and thus assist in saving patients' lives and improving their health outcomes. A considerable amount of spatial optimization research has been devoted to the development of models to support location planning in the context of EMS, with extensive...

Improvement of the equality of geographical allocation of limited health-care resources requires an accurate evaluation of spatial accessibility of the facilities. The adoption of appropriate population distribution measures is one of the leading factors affecting such an evaluation. Using primary health-care institutions in Hainan, China as an exa...

Evidence from high-income countries suggests that depressive symptoms may mediate the relationship between smoking and pain. However, the relationship remains poorly understood for the population in low- and middle-income countries (LMICs), who account for 80% of the current tobacco consumers. Using cross-sectional data from a nationally representa...