Xing Lin Feng

• PhD
• Peking University School of Public Health

Background We evaluated a large-scale pilot program in Shaanxi Province, western rural China, which integrated prenatal screening interventions for congenital abnormalities into routine antenatal programs. Methods We surveyed 1,597 mothers who gave birth between 2009 and 2016. Adopting the interrupted time-series design, we evaluated the program's...

High drug costs are putting pressures on health care budgets and posing an obstacle for China to achieve universal coverage. Policies such as the direct price ceiling, and the Essential Medicines Program-with the Zero Markup Drug Policy (ZMDP) one key component-were implemented, coming out with limited evidence for a success. As a benchmark of Chin...

We adopted a difference-in-difference (DID) design to evaluate the impact of a case-based payment pilot in Tianjin, China on hospital admission, utilization of varied therapeutic regimes, and the associated costs. We used claim data of all admissions of angina and acute myocardial infarction during July 2015 to June 2018, 18 months before and after...

Introduction We comprehensively evaluate whether the Chinese Government’s goal of ensuring Universal Health Coverage for essential health services has been achieved. Methods We used data from the 2008, 2013 and 2018 National Health Services Survey to report on the coverage of a range of Sustainable Development Goals (SDG) indicator 3.8.1. We creat...

Objectives To assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China’s poorest rural counties. Design Six consecutive cross sectional surveys were conducted annually. Setting The study was conducted in 116 counties in 19 provinces from 2016 to 2021, representing China’s 832 poorest c...

Objectives This study aimed to understand disposal practices of unwanted medications in Chinese households and examine associations between influencing factors and these disposal practices. Design A nationwide cross-sectional study conducted between 11 October and 26 October 2018. Setting Municipalities directly under the central government and p...

Generic substitutions are globally considered to contain health expenditures. Yet it is uncertain whether the costs spill over to other medicines or health services. Contextualizing China’s National Volume-Based Procurement (NVBP) policy, which promoted generic substitution, this study tests the changes in patients’ utilization of generic medicines...

Background Chatbots can provide immediate assistance tailored to patients’ needs, making them suitable for sustained accompanying interventions. Nevertheless, there is currently no evidence regarding their acceptability by hypertensive patients and the factors influencing the acceptability in the real-world. Existing evaluation scales often focus s...

Background Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson’s disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are ava...

This study aims to assess clinical outcomes following switching from originator to generic amlodipine. This population‐based, matched, cohort study included users of originator amlodipine using claims data during 2018–2020 from a health system in Tianjin, China, in which usage of generic amlodipine was promoted by a drug procurement policy, the nat...

Leveraging substantial data from China’s Weibo and datasets from Reddit and X (previously Twitter) in the United States, this research explores the disparities and complex dynamics of emotions and social connections among social media users in China and the United States during the COVID-19 pandemic. The findings indicate that the expression of thr...

This cohort study used the China Health and Retirement Longitudinal Study (CHARLS, 2015–2018) to investigate the effects of socioeconomic status and social capital to the incidence of depressive symptoms among middle-aged and older individuals in China, incorporating a sample size of 9949 participants. Socioeconomic status, social capital and other...

Background This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution. Methods We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan provin...

Background Chatbots can provide immediate assistance tailored to patients' needs, making them suitable for sustained accompanying interventions. Nevertheless, there is currently no evidence regarding their acceptability by hypertensive patients and the factors influencing the acceptability in the real-world. Existing evaluation scales often focus s...

Background: Contextualizing in China's recent health reform, we empirically explore the heterogeneous effects of two distinct government roles, accommodating private hospitals vs investing in public hospitals, on health system efficiency. Methods: We use panel data covering 31 provinces during 2010-2019 to assess health system efficiency. We inc...

Background Sarcopenia is a common geriatric disease. Many dietary factors may contribute to the development of sarcopenia. Few studies have been conducted on dietary diversity and sarcopenia in Chinese older adults. Among a nationwide sample, the objective of this study is to assess the association between the dietary diversity score (DDS) and the...

To explore the effects of UNICEF-suggested modifiable factors, that is, water, sanitation and hygiene (WASH), early adequate feeding and health care on child malnutrition, and to examine the extent to which each factor contributes to urban-rural disparities of child malnutrition in China. Pooling two waves of regionally representative survey data f...

Abstract Background This study was conducted to investigate the prevalence and determinants of breastfeeding in 2008 and 2018, respectively, in Northeast China, where health service efficiency is at the lowest national level and regional data on breastfeeding are lacking. The influence of early initiation of breastfeeding on later feeding practices...

Objective Direct-to-consumer telemedicine is rapidly changing the way that patients seek medical care. This study provided the first report on access, cost and quality of text- and image-based tele-dermatology e-consults, in China. Methods We adopted the Standardized Patients approach to evaluate the services of tele-dermatology e-consults in two...

Background Air pollution has been identified as related to the diseases of susceptible population, but the spatial heterogeneity of its economic burden and its determinants are rarely investigated. The issue is of great policy significance, especially after the epidemic of COVID-19, when human are facing the joint crisis of health and environment,...

Background The WeChat platform has become a primary source for medical information in China. However, no study has been conducted to explore the quality of information on WeChat for the treatment of hypertension, the leading chronic condition. Objective This study aimed to explore the quality of information in articles on WeChat that are related t...

Objective Cervical cancer, the fourth leading cancer diagnosed in women, has brought great attention to cervical cancer screening to eliminate cervical cancer. In this study, we analyzed two waves of provincially representative data from northeastern China's National Health Services Survey (NHSS) in 2013 and 2018, to investigate the temporal change...

Background Consultation length, the time a health provider spend with the patient during a consultation, is a crucial aspect of patient-physician interaction. Prior studies that assessed the relationship between consultation length and quality of care were mainly based on offline visits. Research was lacking in E-consults settings, an emerging moda...

IntroductionThe aim of this study was to explore a method to rank the cost-effectiveness of presbyopia correction in diverse strategies of bilateral cataract surgery to provide references for healthcare policymakers in rationalizing resource utilization and surgeons in customizing patient management.Methods The cost-effectiveness analysis based on...

China’s healthcare system has been challenged by patient dissatisfaction with primary care and an increased tendency toward visiting high-level general hospitals, which undermine the vision of a hierarchical diagnosis and treatment system. Using the game theory, we built a model that incorporated patients’ preferences and use of healthcare faciliti...

Inadequate feeding is one of the most critical underlying determinants of child malnutrition. In this study, we explore infant young child feeding (IYCF) and deconstruct breastfeeding barriers in mothers of severely malnourished children in one of the most marginalized districts of Punjab province of Pakistan. Using purposive sampling, 20 lactating...

With the expansion of vaccination programs, the policy of terminating nonpharmaceutical interventions for preventing the SARS-CoV-2 pandemic should become more flexible. The current study investigated the clinical and economic outcomes of intervention policies combining nonpharmaceutical interventions and vaccination programs for dealing with the S...

The Coronavirus Disease 2019 (COVID-19) pandemic has caused numerous unexpected changes for families and societies, which have likely contributed to higher amounts of stress for most parents. This study aimed to examine the relationship between burnout and mental health among parents during the COVID-19. Pandemic exposure and household factors (e.g...

Background: Detection of depression gained prominence soon after this troublesome disease emerged as a serious public health concern worldwide. Objective: This systematic review aims to summarize the findings of previous studies concerning applying machine learning (ML) methods to text data from social media to detect depressive symptoms and to sug...

The authors regret that the following funders information was not included in the original publication “This work was supported by the China National Natural Science Foundation (71761130083, 71422009).” The authors would like to apologise for any inconvenience caused.

Objective: We assessed factors associated with frequency and contents of antenatal care (ANC) in remote rural China, including province of residence and individual level factors. Design: Survey-based cross-sectional study. Setting: Remote rural China, Five provinces- Jilin, Shaanxi, Hunan, Guizhou, and Ningxia. Sample: 3,918 women with a liv...

Background: Globally, diabetes has brought an enormous burden to public health resources, and the situation of disease burden caused by diabetes in China is especially severe. China is currently facing the dual threat of aging and diabetes, and wearable activity trackers could promote elderly diabetic patients' physical activity levels and help the...

Backgrounds Non-communicable diseases (NCDs) have become a priority public health issue. The aim of this study was to examine whether socio-economic inequalities exist in chronic disease management among Chinese adults, and whether the relationship between SES and chronic disease management mediated by social capital. Methods We used combined data...

Background: There have been very limited prospective studies examining social-cognitive models within stages of behavior change in the exercise domain. Purpose: We examined the utility of the theory of planned behavior (TPB), incorporating self-identity and descriptive norm constructs, to predict exercise behavior across the stages of change, in in...

Background Ambient air pollution is leading risk factor for health burden in China. Few studies in China have investigated the economic loss related to short-term exposure to ambient PM2.5, which could trigger acute onset of cardiorespiratory diseases within a few days. Methods Daily ambient air pollutants data are obtained for each city from the...

Background : Given that multimorbidity is strongly associated with disability in activities of daily living (ADL) and the mechanism still remains unclear, this study sought to investigate the mediating effect of depression on such association. Methods : A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARL...

Objective To understand the current situation and predict the trends in number and composition of prenatal ultrasound screening staff in Beijing. Methods We analyzed the region,age,professional title and other characteristics of prenatal ultrasound screening personnel in Beijing during 2007-2015.We then built an ARIMA model basing on the current si...

Internet addiction among high school students is an emerging public health issue in China. The objective of this study was to investigate the association between internet addiction and quality of life, as well as the mediation effect of social support in such an association, among Chinese rural high school students. A total of 1277 high school stud...

Purpose Digital healthcare has become one of the most important Internet applications in the recent years, and digital platforms have been acting as interfaces between the patients and physicians. Although these technologies enhance patient convenience, they create new challenges in platform management. For instance, on physician rating websites, i...

Objective: To investigate the association between educational attainment and the onset of disability in activities of daily living (ADL), and to explore the mediating effect of social participation on such association. Methods: A longitudinal dataset was drawn from the China Health and Retirement Longitudinal Study (CHARLS, 2015 to 2018). The me...

Background: The Coronavirus Diseases (COVID-19) pandemic is a global public health challenge and provides an opportunity to investigate the unclear relationship between risk perception, social support, and mental health. This study aims to examine the association between risk perception and mental health while taking social support as a moderator....

BackgroundsNon-communicable diseases (NCDs) have become a priority public health issue. The aim of this study was to examine whether social-economic inequalities exist in chronic disease management among Chinese adults, and whether the relationship between SES and chronic disease management mediated by social capital.Methods We used combined data f...

Background China set out the vision to establishing a hierarchical medical system, with primary health care (PHC) facilities serving health care users’ first contact. Common ailments were listed, supported by a series of auxiliary policy measures. We aim to assess whether these policies were effective to prompt users’ preference to PHCs within thes...

BACKGROUND Detection of depression gained prominence soon after this troublesome disease emerged as a serious public health concern worldwide. OBJECTIVE The aim of this review intends to summarize methods to measure depressive symptoms on social media by machine learning approaches. METHODS A bibliographic retrieval was conducted from January 199...

Objectives: We aim to analyze equity in maternal, newborn, and child health (MNCH) interventions in Jilin, a northeastern province of China, 2008–2018. Study design: Cross-sectional study. Methods: We used provincially representative survey data from 2008, 2013, and 2018. We included 18 essential MNCH interventions, analyzed equity, and calculated...

Objectives This study was aimed to develop a health belief model scale for exercise among Chinese residents to describe the relationships between health beliefs and exercise for promoting residents to adopt or maintain exercise programs. Methods Participants were from two projects, Project 1 with 3833 participants and Project 2 with 7319 participa...

Objective To analyze the efficiency of prenatal ultrasound screening service in Beijing and thus optimize the secondary prevention system for birth defects in Beijing. Methods Data were collected from the prenatal screening work reports of Beijing from 2010-2016.Key variables were extracted after data quality control.Data envelopment analysis was p...

The COVID-19 pandemic might lead to more mental health problems. However, few studies have examined sleep problems, depression, and posttraumatic symptoms among the general adult population during the COVID-19 outbreak, and little is known about coping behaviors. This survey was conducted online in China from February 1st to February 10th, 2020. Qu...

Objective To learn the capability and functioning status of prenatal ultrasound screening institutions in Beijing and inform decision-making on the optimization of prenatal screening management. Method By using the data from the second and the third National Special Survey on Prenatal Screening and Prenatal Diagnostic Services in Beijing,we analyze...

Policy makers in China are considering consolidating the country’s fragmented health insurance programs. This system consists of three components. The Urban Employee Basic Medical Insurance (UEBMI) covers formal employees, the New Cooperative Medical Scheme (NCMS) covers rural residents, and the Urban Resident Basic Medical Insurance (URBMI) covers...

Objective: To construct composite indicators of maternal and child's basic health services using different weights from the prospective of continuum of care and to compare them based on data from the National Health Services Survey 2008 and 2013 in Jilin Province. Methods: The study selected indicators based on the countdown and the Lives Saved Too...

Objective: To investigate the present situation and influencing factors of the hierarchical medical system among middle-aged and elderly patients and provide policy suggestions for the reform of hierarchical medical system in China. Methods: According to the baseline data of China Health and Retirement Longitudinal Study(CHARLS) in 2011 and trackin...

Background China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village...

Objectives: To provide an assessment of China's progress to universal health care from the perspective of people-centred care. Methods: We obtained data on 28,103 participants from the China Health and Retirement Longitudinal Study during 2011-2013. Logistic regressions and generalized linear models were used to analyse care-seeking behaviours a...

To investigate the outpatient provider preference and its influencing factors among residents older than 45 years in China's urban areas. The data of China Health and Retirement Longitudinal Survey (CHARLS) taking place in the year 2011 were analyzed with the method of multinominal logistic regression. In the last month, the rates of respondents wi...

Objective To review the current knowledge on the prevalence, reasons, and consequences of cesarean sections in the People’s Republic of China. Methods Peer-reviewed articles were systematically searched on PubMed. The following Chinese databases were comprehensively searched: the China National Knowledge Infrastructure, Wanfang, and the VIP inform...

To monitor hypertension prevalence, awareness, treatment and control in China two to three years after major reform of the health system. Data from a national survey conducted in 2011-2012 among Chinese people aged 45 years or older - which included detailed anthropometric measurements - were used to estimate the prevalence of hypertension and the...

Between 1990 and 2006, China reduced its under-five mortality rate (U5MR) from 64.6 to 20.6 per 1000 live births and achieved the fourth United Nation's Millennium Development Goal nine years ahead of target. This study explores the contribution of social, economic and political determinants, health system and policy determinants, and health progra...

OBJECTIVE: To identify factors driving the rapid increase in caesarean section in China between 1988 and 2008. METHODS: Data from four national cross-sectional surveys (1993, 1998, 2003 and 2008) and modified Poisson regression were used to determine whether changes in household income, access to health insurance or women's education accounted for...

(BJOG. 2010;117(6):1527–36)

China's success in improving the quality of and access to obstetric care in hospitals offers an opportunity to examine the effect of a large-scale facility-based strategy on neonatal mortality. We aimed to establish this effect by assessing how the institutional strategy of intrapartum care has affected neonatal mortality and its regional inequalit...

Objective China was one of the 68 “countdown” countries prioritized to attain Millennium Development Goals (MDG 4). The aim of this study was to analyze data on child survival and health care coverage of proven cost-effective interventions in China, with a focus on national disparities. Methods National maternal and child mortality surveillance dat...

China was categorized as one of the 68 "countdown" countries to achieve the United Nations Millennium Development Goals (MDG) 5. This paper aimed to analyze the situation of maternal survival, and coverage of proven cost effective interventions in China, where specific attention was paid to disparities. National maternal and child mortality surveil...

To assess trends in hospital births in China during 1988-2008 in an effort to determine if efforts to overcome financial barriers to giving birth in hospital have reduced the access gap between the rich and the poor. Cross-sectional data obtained from four National Health Service Surveys were used to determine trends in hospital births during 1988-...

China's economic reforms have raised concerns over rising inequalities in maternal mortality, but it is not known whether the gap across socio-economic regions has increased over time. A population-based, longitudinal, ecological correlation study. China. Records from the National Maternal and Child Mortality Surveillance System between 1996 and 20...

Using 11 years of county-level panel data, fixed effect models are estimated to evaluate the impact of the Safe Motherhood (SM) Program in China. Propensity score matching is used to select comparable factual and counterfactual counties. Out of 2013 counties in China, 283 are selected for the treatment group and 1051 for the control group. The resu...

To investigate the impact of social determinants of health on the inequality of child health and health care utilization. Information of 1 118 children aged 0 to 16 is extracted from the Chinese Family Panel Studies (CFPS) year 2008 cross sectional survey data for the analysis. Age standardized concentration curves and concentration indices are emp...

Previous estimates of the global burden of disease for children have not included much information from China, leading to a large gap in data. We identified the main causes of deaths in neonates (<1 month), postneonatal infants (1-11 months), and children (<5 years) in China using information that was available to the public. The Child Health Epide...

To explore the need for faculty development among Chinese medical educators. Leaders at each medical school in China were asked to complete a 123-item survey to identify interest in various topics and barriers and perceived benefits of participating in faculty development programs. Interest levels were high for all topics. Experience with Hospital...