How does preference disclosure by political principals shape regulatory outcomes downstream? While existing literature approaches this question in terms of principal-agent maneuvers, we argue that how leaders reveal their policy preferences and the effect on regulatory behavior can be understood through the lens of information processing. In-depth interviews with elite actors in China's film sector indicate that leaders facing elite contestation limit disclosure to stabilize coalition support, whereas leaders free from such contestation often comment directly and expansively on regulatory decisions, while tying their revealed preferences to "big picture" considerations beyond the business of filmmaking. The expanded scope and scale of disclosure following regime consolidation transformed the informational environment for the film sector, prompting regulators to prioritize out-of-domain issues and curtail discretionary action to mitigate political risk. The findings point to the informational determinants of regulatory behavior in comparative settings.

Citizen-generated data plays a pivotal role in improving environmental policy design, refining policy instrument selection, and enhancing governance precision. However, the specific mechanisms through which such data influences policy processes remain underexplored. This study utilizes the BERT language model to classify public sentiment, incorporating it as a labeled variable within the policy process. Using data from Fuzhou's 12345 public service platform, the research investigates the role of citizen-generated data in shaping environmental policy, specifically focusing on black-odor water management. The findings show that government responses to public demands are influenced by institutional trust, willingness to participate, and individual normative adherence. For individuals with high institutional trust, governments tend to use nudging strategies for psychological engagement, while those with strong willingness to participate see expedited administrative interventions. Long-term complainants, particularly those motivated by self-interest, are more likely to receive informational responses over direct administrative enforcement. Additionally, the influence of citizen-generated data on policy design is mediated through three key mechanisms: the focal effect, inertia effect, and cost effect. This study underscores the need for a robust link between citizen-generated data and policy design, emphasizing the importance of emotional governance and AI-driven strategies to improve the effectiveness of environmental policymaking.

Unmet healthcare needs remain a major barrier to achieving universal health coverage (UHC) globally. The intersection of aging and disability intensifies individual vulnerability and deepens structural health inequalities. Using Andersen's Behavioural Model of healthcare utilisation as the theoretical framework, this study examines the determinants of healthcare utilisation at the individual and contextual levels among older adults with disabilities living in China. We use a dataset in China from 319 prefectures, with a total sample size of 634,445 individuals. Our findings reveal the presence of higher-income and urban-residence advantages in healthcare utilisation for older adults with disabilities in China. Regional economic development positively affects healthcare utilisation and reduces urban-rural inequality in healthcare utilisation, but its impact on income-based inequality is limited. These results highlight the need for targeted social assistance programmes for low-income groups to promote universal healthcare coverage and social equity.

Resource allocation is crucial for local governments to effectively achieve their policy objectives. However, there is a gap in studies regarding how local government's diverse resources are strategically allocated. This study contributes an additional explanation for local government resource allocation in the context of the 'Targeted Poverty Alleviation' in China. Stakeholder theory provides a comprehensive view of the influences of central and local governments. Evidence was derived from a panel dataset for the 2014-2020 period, along with 30 semi-structured interviews. Our findings indicate stakeholders exert heterogeneous influences on local government resource allocation: the central government dominantly impacts fiscal resource allocation, whereas local governments demonstrate significant autonomy in allocating both fiscal and human resources, showing significant regional variation. These findings challenge the conventional assumption that the central government acts as a principal while local governments function as agents making solitary decisions. This article offers valuable insights into public management theory by highlighting stakeholders' diverse roles in shaping local government resource allocation decisions.

Previous research overlooks the impact of city shrinkage on disadvantaged groups. This study explores the relationship between city shrinkage and public service delivery for people with disabilities. First, principal component analysis was employed to measure the public service facility coverage index for people with disabilities, highlighting the spatial characteristics in China. Second, a regression discontinuity design was utilized to analyze the causal relationship between city shrinkage and public service. Third, ordinary least squares regression was used to identify key factors affecting public services coverage. The results showed that the population change in prefecture-level cities has widened the gap in public service delivery for people with disabilities. Places stratification within cities has been enlarged by city shrinkage. Notably, the impact of city shrinkage is predominantly observed in the periphery of cities; due to better-developed public service facilities in urban centers, the effect of city shrinkage is less pronounced there. Additionally, factors such as financial autonomy and disabled population density significantly influence the delivery of public services for people with disabilities. These findings suggest that policy-making should be tailored to urban dynamics and shrinking cities should adopt targeted strategies to enhance public services for disadvantaged people.

Background:Addressing the problem of disabilities and disability deterioration is a key task for healthy ageing. Financial aid has been an effective measure for vulnerable groups, especially ageing people with disabilities. However, the effects of targeted financial aid on preventing disability deterioration remain unknown. The Chinese government launched a targeted financial aid programme aimed at people with disabilities. In this study, we investigated the causal effects of such targeted financial aid on disability deterioration prevention for elderly people with disabilities in China. Methods:The data set used in this study included 36 640 elderly individuals with disabilities in China between 2016-19. We constructed a quasi-experiment approach and used a difference-in-differences (DID) method to examine the counterfactual differences between the treatment group in four cities that implemented such targeted financial aid in 2018 and the control group in three cities that did not adopt the policy over the study period. We employed propensity score matching (PSM) jointly with DID to mitigate selective bias. For sensitivity analysis, we conducted supplementary analyses on alternative samples, focusing on each of the treated cities respectively. Besides the main outcome, we also used fixed effect models to test the impact of such financial aid on rehabilitation access. Results:The targeted financial aid significantly reduced the possibility of disability deterioration for elderly people with severe disabilities (0.26%; P < 0.001). Using PSM-DID models, the impact remained significant (0.33%; P < 0.001). Moreover, financial aid was significantly related to their access to rehabilitation services (12.71%; P < 0.001). Further analysis showed the heterogenous effects of targeted financial aid across individual demographic and socioeconomic factors, as well as communities with and without rehabilitation facilities. Conclusions:Targeted financial aid had a positive impact on preventing disability deterioration among elderly individuals aged ≥65 years with severe disabilities. Moreover, rehabilitation care had a potential mediating role in the relationship between targeted financial aid and disability deterioration prevention. This study highlights the effectiveness of targeted financial aid in preventing disability deterioration and improving rehabilitation care for people with disabilities.

This paper proposes a new index that measures the development level of public services for people with disabilities. Based on the framework of territorial justice, the measure examines the equity in the spatial allocation of public service resources for disadvantaged groups. Taking China as a case, this study uses principal component analysis to construct the Public Service Facility Coverage Index for persons with disabilities. It also employs cluster analysis and spatial econometrics methods to analyze the spatial characteristics of public service facilities for persons with disabilities. Findings reveal that public service facilities for persons with disabilities can be divided into four coverage clusters—very high, high, medium, and low—with significant regional disparities among them. This article also found a significant regional spatial variation in public service facilities for persons with disabilities. Specifically, public service facilities for persons with disabilities in eastern regions were obviously higher than in other regions, mainly due to regional differences in financial autonomy, the density of the disabled population, and urbanization. The above shows that the opportunities for accessing public services still differ within a territorial entity. The realization of territorial justice requires strengthening the government’s governance capacity.

BackgroundThe equity of public resources triggered by city shrinkage is a global challenge. Significantly, the impact of city shrinkage on the allocation of health service resources needs to be better understood. This study explores the impact of population change on government investment and health service delivery in shrinking cities.Data and methodUsing data from China’s Urban Statistical Yearbook (2010–2020), we employ regression discontinuity (RD) and fixed-effect models to examine the causal relationship between city shrinkage and health service provision.ResultShrinking cities show significant disparities in health resources, particularly in bed numbers (−1,167.58, p < 0.05) and doctor availability (−538.54, p < 0.05). Economic development (p < 0.01) and financial autonomy (p < 0.01) influence hospital bed distribution. Investments in public services (primary schools and teachers, p < 0.01) affect health resource delivery. Robustness tests support our results.ConclusionThis study reveals how city shrinkage disrupts health service provision and equity, establishing a causal relationship between city shrinkage/expansion and health resource allocation, emphasizing the imbalance caused by urban population changes. City expansion intensifies competition for health resources, while shrinking cities struggle to provide adequate resources due to government reluctance. Policymakers should adapt health resource allocation strategies to meet patient demands in changing urban landscapes.

ObjectivesHealth policy attention (HPA) refers to the extent of attention given by governments to health issues in public policy and is generally influenced by socioeconomic development. This study aimed to examine the spatiotemporal heterogeneity and clustering of the associations between socioeconomic factors and HPA.Study designLongitudinal study.MethodsThis study examined the spatiotemporal heterogeneity of the association between public and provincial government attention, economic development, and demographic transition and HPA by using geographically and temporally weighted regression (GTWR). Word2Vec machine learning technology was utilized to calculate HPA data in 323 cities and independent variable data was collected in each city in China over the period of 2018–2021.ResultsThe results showed that there is a substantial overall rise in HPA levels throughout China following the COVID-19 pandemic. Furthermore, the GTWR results revealed significant spatiotemporal heterogeneity in the associations between HPA and public and provincial government attention, economic development, and demographic transition, particularly in the context of COVID-19. The impact of provincial government attention on HPA decreased from the capital of the political center outward, while the impact of public financial investment decreased in less developed cities during the pandemic. It was only cities with high levels of aging are more likely to receive greater HPA.ConclusionThe finding highlighted the remarkable spatial and temporal variations in the associations between the variables and HPA across different regions in China, emphasizing the need for region-specific policies to strengthen the focus on health by municipal governments.

This study gathered empirical evidence of the spatial distribution characteristics of urban public transport services and their impact on regional equity. We used the entropy weighting analysis method to calculate the urban public transport service index based on multi-source geographic and transportation services data in China. QAP (Quadratic Assignment Procedure) regression was used to explore the factors affecting differences in traffic service. Our results showed a significant gap among regions. Prefecture-level cities with highly-developed economies, large geographical areas, or special status (such as province capitals) had high transportation service levels. Transportation services inequity was caused by the economic base of different local governments, resulting in differences in their financial support for public services. We also found that the disparity in transportation services narrowed over time, indicating that transportation service investment has long-term effects. The study's findings show the impact of urban development on transport service equity in developing countries.

Meeting the healthcare needs of people with disabilities is an important challenge in achieving the central promise of “leave no one behind” during the Sustainable Development Goals era. In this study, we describe the accessibility of healthcare for people living with disabilities, as well as the potential influences of individuals’ socioeconomic status and regional economic development. Our data covered 324 prefectural cities in China in 2019 and captured the access to healthcare services for people with disabilities. First, we used linear probability regression models to investigate the association between individual socioeconomic status, including residence, poverty status, education, and healthcare access. Second, we conducted an ecological analysis to test the association between prefectural economic indicators, including GDP (gross domestic product) per capita, urbanization ratio, average years of education, Engel’s coefficient, and the overall prevalence of access to healthcare for people with disabilities within prefectures. Third, we used multilevel regression models to explore the association between the individual’s socio-economic status, prefectural economic indicators, and access to healthcare at the individual level for people with disabilities. The results showed, first, that higher individual socioeconomic status (urban residence or higher educational level) was associated with better access to healthcare for people with disabilities. Second, regional economic indicators were positively associated with access to healthcare at the aggregate and individual levels. This study suggests that local governments, particularly in low- and middle-income countries, should promote economic development and conduct poverty alleviation policies to improve healthcare access for disadvantaged groups.

BACKGROUND:Cash transfer is a crucial policy tool to address inequality. The objective of this study was to investigate the association between China's disability-targeted cash transfer programme and disability status, as well as equitable access to rehabilitation and medical services. METHODS:For this quasi-experimental study, we drew data from the nationwide administrative cohort of individuals with disabilities between Jan 1, 2015, and Dec 31, 2019. Individuals were enrolled in the cohort if they were aged 18 years or older, had severe disabilities as defined by the Chinese Government, and had available cash transfer information for at least 4 consecutive years, without having started receiving cash transfer benefits at the time of enrolment. We used a quasi-experimental design with propensity score matching to estimate the effects of cash transfers on disability status, access to rehabilitation services, and access to medical treatment. The primary outcomes were development of new disability and reduction of existing disabilities. Secondary outcomes were use of rehabilitation services, financial barriers as a major obstacle to accessing rehabilitation services, use of medical services by individuals who had an illness in the previous 2 weeks, and financial barriers as a major obstacle to accessing medical services. FINDINGS:From an initial pool of 51 356 125 individuals with disabilities registered in the administrative system, 2 686 024 individuals were eligible for analysis, of whom 2 165 335 (80·6%) were cash transfer beneficiaries and 520 689 (19·4%) non-beneficiaries. After propensity score matching, the cohort included 4 330 122 adults with severe disabilities. Cash transfer beneficiaries had significantly lower odds of developing new disabilities over time than non-beneficiaries (odds ratio [OR] 0·90, 95% CI 0·86-0·94; p<0·0001) and higher odds of having a reduced number of disabilities over time (1·17, 1·10-1·25; p<0·0001). Compared with non-beneficiaries, cash transfer beneficiaries were more likely to use rehabilitation services (2·12, 2·11-2·13; p<0·0001) and medical services (1·74, 1·69-1·78; p<0·0001), and less likely to report financial hardship to access rehabilitation services (0·53, 0·52-0·54; p<0·0001) and medical services (0·88, 0·84-0·93; p<0·0001) at the study endpoint. INTERPRETATION:The receipt of cash transfers was associated with improved disability status and increased access to disability-related services. The findings suggest that cash transfers could be a potential method for promoting universal health coverage among individuals living with disabilities. FUNDING:China National Natural Science Foundation.

Prior research has overlooked the dynamics between government responsiveness and citizen satisfaction. This article addresses this gap by examining (1) how styles of government responses affect citizen satisfaction differently and (2) how external events moderate the effects of government responsiveness on citizens. Drawing upon 79,360 environmental demands sent to local leaders in China and 100,905 Chinese citizens' environmental assessments collected from 2013 to 18, this study finds that actional and explanatory responses positively influence citizen satisfaction, while referral responses negatively affect citizen satisfaction. Moreover, these relationships are subject to the moderating effects of exogenous pressures. Top-down pressure from the central government's environmental inspections and bottom-up pressure from the environmental documentary Under the Dome represent two types of exogeneities during the study period. The findings corroborate a dynamic government-citizen relationship that is shaped by government responding actions and sociopolitical changes.

Background Cash transfer is a crucial policy tool to address inequality. The objective of this study was to investigate the association between China's disability-targeted cash transfer programme and disability status, as well as equitable access to rehabilitation and medical services.Methods For this quasi-experimental study, we drew data from the nationwide administrative cohort of individuals with disabilities between Jan 1, 2015, and Dec 31, 2019. Individuals were enrolled in the cohort if they were aged 18 years or older, had severe disabilities as defined by the Chinese Government, and had available cash transfer information for at least 4 consecutive years, without having started receiving cash transfer benefits at the time of enrolment. We used a quasi-experimental design with propensity score matching to estimate the effects of cash transfers on disability status, access to rehabilitation services, and access to medical treatment. The primary outcomes were development of new disability and reduction of existing disabilities. Secondary outcomes were use of rehabilitation services, financial barriers as a major obstacle to accessing rehabilitation services, use of medical services by individuals who had an illness in the previous 2 weeks, and financial barriers as a major obstacle to accessing medical services.Findings From an initial pool of 51 356 125 individuals with disabilities registered in the administrative system, 2 686 024 individuals were eligible for analysis, of whom 2 165 335 (806%) were cash transfer beneficiaries and 520 689 (194%) non-beneficiaries. After propensity score matching, the cohort included 4 330 122 adults with severe disabilities. Cash transfer beneficiaries had significantly lower odds of developing new disabilities over time than non-beneficiaries (odds ratio [OR] 090, 95% CI 086-094; p<00001) and higher odds of having a reduced number of disabilities over time (117, 110-125; p<00001). Compared with non-beneficiaries, cash transfer beneficiaries were more likely to use rehabilitation services (212, 211-213; p<00001) and medical services (174, 169-178; p<00001), and less likely to report financial hardship to access rehabilitation services (053, 052-054; p<00001) and medical services (088, 084-093; p<00001) at the study endpoint.Interpretation The receipt of cash transfers was associated with improved disability status and increased access to disability-related services. The findings suggest that cash transfers could be a potential method for promoting universal health coverage among individuals living with disabilities.

Background:To achieve improved outcomes for children and adolescents with disabilities, it is central to have universal health coverage (UHC) and universal access to education. This study investigates whether a disability-targeted cash transfer (CT) program is associated with improved access to healthcare and education for children and adolescents with disabilities.Methods:We used nationwide survey data of two million children and adolescents living with disabilities, who aged 8-15 years when entering the cohort between January 1, 2015, and December 31, 2019. With a quasi-experimental study design, we compared the outcomes between CT beneficiaries who newly received CT benefits during the study period and non-beneficiaries who were disabled but never received CT using logistic regressions after propensity score matching with a 1:1 ratio. Outcomes of interest were utilization of rehabilitation services in the past year, medical treatment if the individual had illness in the past two weeks, school attendance if not in school at the start of the study, and reported financial hardship to access these services.Findings:Of the total cohort, 368,595 children and adolescents fit the inclusion criteria, including 157,707 new CT beneficiaries and 210,888 non-beneficiaries. After matching, CT beneficiaries showed 2.27 (95% confidence interval [CI]: 2.23, 2.31) higher odds of utilizing rehabilitation services and 1.34 (95% CI: 1.23, 1.46) higher odds of getting medical treatment compared to non-beneficiaries. CT benefits were also significantly associated with less report of financial barrier to access rehabilitation services (odds ratio [OR]: 0.63, 95% CI: 0.60, 0.66) and medical treatment (OR: 0.66, 95% CI: 0.57, 0.78). Moreover, CT program was associated with higher odds of school attendance (OR: 1.99, 95% CI: 1.85, 2.15) and lower odds of reporting financial difficult to access education (OR: 0.41, 95% CI: 0.36, 0.47).Interpretation:Our results suggest that the receipt of CT was associated with improved access to health and educational resources. This finding provides supporting evidence for the identification of efficient and feasible interventions to move toward UHC and universal education under the Sustainable Development Goals.Funding:This research was supported by Sanming Project of Medicine in Shenzhen (NO.SZSM202111001), China National Natural Science Foundation (Grant/Award Number: 72274104, 71904099) and Tsinghua University Spring Breeze Fund (20213080028).

Background Extensive research has explored disparities in access to health care between people with and without disabilities, but much less is understood about disparities and associated factors within the disabled population. Objective The aim of this study was to examine differences in the prevalence of unmet health-care needs by residential status (hukou status) and disability type among people with disabilities. Methods Our data were from the National Survey on Basic Public Service Delivery of Persons with Disabilities. The analysis sample included a nationally representative sample of 9 642 112 adults (aged 16+ years) with disabilities. Associated factors were obtained at both individual level and community level. Cross-sectional multivariable logistic regression analyses were conducted to compare unmet medical, care, rehabilitation and accessibility needs among people with different residential statuses and different types of disabilities. Results The estimated prevalence of unmet medical, care, rehabilitation and accessibility needs is 15.4%, 10.2%, 45.6% and 13.7%, respectively. Rural hukou was associated with an important 13-40% increase in unmet health-care needs for people with disabilities in China. These rural-urban disparities in unmet health service needs can be partly explained by community-level factors, including access to facilities, social participation and health professionals. Disparities across the type of disability were smaller, but on average, people with multiple disabilities appeared to have the highest rates of unmet care, medical and accessibility needs, whereas those with physical disability had the highest unmet rehabilitation need. Conclusions Differences by residential status and impairment type were evident in all types of unmet health service needs. Targeted policy designs that meet the needs for justice and equality of people with disabilities are advisable. Public health and policy efforts are required to improve access to health service and meet the needs of people with disabilities, especially in rural practices and for particular disability groups.

我国老年残疾人口规模持续扩大且面临医疗资源利用不足的困境.老年残疾人的医疗康复服务利用与个体因素及环境因素相关.在个体层面,老年残疾人的医疗康复服务利用存在性别、年龄、婚姻状况、受教育程度、户口性质上的显著差异;在环境层面,文化隔离、信息壁垒与物理障碍是造成老年残疾人医疗康复服务利用不平等的三重结构性因素.由环境因素导致的老年残疾人医疗康复服务利用不平等实质上是一种机会不平等,需要由政府、市场和社会工作者多方参与,促进老年残疾人的社会融合,加强残疾相关医疗和社会工作队伍建设,促进社区基本公共卫生服务均等化,从而提升老年残疾人的医疗资源服务利用程度.

This paper compares the paths of development taken by China and Malaysia in their attempts to pursue catching-up. While both China and Malaysia rely to a large extent on attracting foreign direct investment, China has, since its economic liberalisation in the late 1970s, implemented a more proactive set of industrial policy to embed foreign know-how and promote domestic technological deepening. This is illustrated through a comparison of the evolution of the Chinese and Malaysian semiconductor (upstream) industry. Although their progress remains tentative at this stage, China seems to be showing more concrete signs of technological and industrial sophistication than Malaysia. Such mastery is a useful platform for Chinese firms to progressively climb the technological ladder and to capture more value from the production and sales of increasingly complex goods and services. The principles discussed in this paper provide policy lessons, or at least some initial guidance, for other developing economies aspiring to move up the value chain.

随着居民公共服务需求增长,社会发展不平衡矛盾更加严峻,财政性公共服务支出压力加大,有限的不平衡的公共服务供给成为人民美好生活需要的现实制约.为此,要构建符合社会主义现代化需要的国家公共服务制度体系,发展混合型公共服务制度,建立公共服务适应性调控机制,建立公共服务职能与责任相匹配监管机制,建立公共服务向民生获得感转化机制,建立新技术手段与公共服务发展融合机制.本文建议,我国用三个五年规划推进公共服务"三步走",促进基本公共服务实现均等化,同时多措并举发展非基本公共服务,加强公共服务治理制度体系建设,提升公共服务治理技术现代化水平.