ObjectiveTo examine the spatiotemporal evolution and equity of traditional Chinese medicine (TCM) service capacity across China from 2012 to 2023 and to provide empirical evidence for improving regional resource allocation.MethodsUsing data on TCM services from the China Health Statistical Yearbook (2013–2024 editions), we constructed a panel dataset for 31 provinces in China covering 2012–2023. Six core indicators were included: outpatient and emergency visits to TCM institutions, number of discharged patients, number of TCM medical and health institutions, number of beds, number of TCM practitioners, and number of staff in TCM hospitals. To improve interprovincial comparability, four contextual indicators were additionally incorporated: gross domestic product per capita, year-end resident population, administrative area, and population density. An entropy-weighting method was used to calculate the composite score of TCM service capacity for each province and year. Spatial dependence was assessed using global Moran's I based on an economic-geographic weight matrix and further examined through local hot spot analysis. Overall disparities, intra-regional disparities, inter-regional disparities, and the contribution of transvariation density were evaluated using the Dagum Gini coefficient and its decomposition.ResultsFrom 2012 to 2023, TCM service capacity in China improved steadily. Outpatient and emergency visits, number of discharged patients, number of TCM medical and health institutions, number of beds, number of TCM practitioners, and number of staff in TCM hospitals increased by 105.5%, 99.0%, 135.0%, 145.4%, 114.0%, and 121.2%, respectively. Composite scores rose in all 31 provinces, with Beijing and Shanghai consistently ranking among the top-performing regions, while Sichuan, Chongqing, Guangdong, and Shandong showed particularly marked improvement. Spatial analysis indicated that global Moran's I was positive and statistically significant in every year, ranging from 0.140 to 0.224, suggesting a stable positive spatial autocorrelation in provincial TCM service capacity. Local spatial patterns were characterized by strengthening hot spots in northern China and relatively stable cold spots in the south. The Dagum Gini coefficient showed that overall national disparities declined from 0.2107 in 2012 to 0.1459 in 2023, with a mean value of 0.1767, indicating an overall convergence trend. Intra-regional disparities were relatively higher in the eastern and western regions and lower in the central and northeastern regions. Inter-regional disparities accounted for the largest share of overall inequality, with a mean contribution rate of 42.57%, exceeding that of intra-regional disparities (28.15%) and transvariation density (29.28%).ConclusionFrom 2012 to 2023, TCM service capacity improved overall across provinces in China, although interprovincial disparities persisted. Overall inequality showed a converging trend and was accompanied by significant spatial clustering. In terms of the sources of disparity, inter-regional differences remained the primary driver of overall inequality, with particularly pronounced gradients between the eastern region and other parts of the country, whereas within-region disparities were relatively small in the central and northeastern regions. Future efforts should therefore focus not only on continued capacity expansion, but also on strengthening cross-regional coordination, optimizing the targeted allocation of resources, and promoting a more spatially balanced distribution of TCM services to improve equity in service capacity.

Traditional Chinese medicine (TCM) is a unique component of China's medical and health system, and the governance of TCM based on its revitalization and development holds significant theoretical and practical implications. This study, from the perspective of TCM revitalization and development, systematically summarizes the strategic positioning of TCM, its role in full-cycle services, and the current status of the entire industrial chain development. The results indicate that the path to modernizing TCM governance should involve refining TCM governance tools and methods through standardization, advancing the modernization of the TCM governance system with a collaborative mindset, and simultaneously constructing the TCM governance system in accordance with the laws of TCM. This study aims to provide possible policy recommendations for the modernization of TCM governance.

Generative artificial intelligence (GenAI) is reshaping medical education while fostering technological dependence among students. This study employed an explanatory sequential mixed-methods design. In the quantitative phase, an empirical analysis was conducted using survey data collected from a sample of 1295 Chinese medical students. The subsequent qualitative phase involved thematic analysis of interview transcripts from 16 medical educators to elucidate the underlying mechanisms. Findings reveal that GenAI was deeply integrated into medical students' daily learning routines. Tool selection favored general-purpose platforms, whereas specialist medical tools exhibited exceptionally low utilization rates. The clinical application possibilities remained below 20% across all situations. With an overall dependency score of 21.91 ± 6.75, over 60% of students reported dependence on GenAI. Multivariate linear regression analysis indicated performance expectancy, academic pressure, and social influence showed significant positive correlations with GenAI dependency. Conversely, critical thinking exhibited a significant negative correlation. Future medical education should strategically reposition GenAI as a "cognitive scaffold" by reinforcing critical thinking and establishing standardized usage guidelines to facilitate high-quality development.

“Three-medical linkage” is a key concern of the healthcare system reform deepening in China, while it has not achieved the expected outcomes yet. The issues of “no-linkage” or “linkage without moving” have increasingly become a major challenge. Data was obtained from various Yearbooks in China. Coupling coordination degree and gravity models were employed to analyze the spatio-temporal evolution pattern of the “three-medical linkage” in 31 provinces. The combination forecasting method was used to forecast the development trend of the “three-medical linkage.” We constructed the obstacle degree model to identify the main obstacles to coordinated development. The overall development of the three systems exhibited a continuous upward trend. The coupling coordination grade of the “three-medical linkage” system has progressed from the disorderly development stage to the transitional stage in most provinces. The Beijing-Tianjin-Hebei and Yangtze River Delta regions are the most closely connected. Regional disparities in the degree of coupling coordination will widen in the future. The number of people benefiting from maternity insurance, per capita total health expenditure, and new drug research and development (R D) costs hindered the coordinated development of the three systems. Highlighting the improvement of the “three-medical linkage” is essential. Under the goals of Healthy China and SDG3 (Good Health and Well-being), further efforts are needed to address systemic barriers and institutional deficiencies. The Chinese government should increase capital input to overcome major obstacles and carefully evaluate the imbalance in regional development.

The effective implementation of vaccination heavily depends on the society’s willingness to pay (WTP). There is currently a dearth of comprehensive evidence about WTP for vaccines in China. This systematic review aims to review studies on the WTP for vaccines, to summarize factors affect WTP in China. Base-case analysis and Sensitivity analysis of WTP for every vaccine were estimated via single-arm Bayesian meta-analysis. A total of 28 studies were included for systematic review. The point estimates and 95% Credible Interval of pooled WTP for influenza and HPV (9-valent) vaccine were $27.409 (23.230, 31.486), $464.707 (441.355, 489.456). Influencing factors to WTP were age, income, peer influence, health condition and etc. Future research should give focus to improving sample representativeness and survey tool, conducting intervention trials, identifying effective methods to promote WTP.

BACKGROUND:To address the public health concern of cervical cancer (CC), 194 countries committed to eliminate it at the initiative of the World Health Organization (WHO). We summarised quantitative results concerning CC elimination across these countries, including the progress in implementing three prevention levels (human papillomavirus [HPV] vaccination, CC screening, and treatment for patients with CC) and achievement of interim Global Strategy for Cervical Cancer Elimination targets. METHODS:Data were obtained from the International Agency for Research on Cancer, WHO, United Nations International Children's Emergency Fund, and country responses to the WHO National Capacity Survey on Non-Communicable Diseases. This retrospective analysis examined data from 194 countries and regions, stratified by national income (high-income countries (HICs) vs low- and middle-income countries (LMICs)) and geographic location (continents such as Europe, Asia, and North America). A quantitative assessment evaluated global progress in primary, secondary, and tertiary CC prevention. RESULTS:By 2020, four countries had achieved Target 1 (90% of girls fully vaccinated against HPV by age 15). A total of 115 countries (51 (44.35%) HICs and 64 (55.65%) LMICs)) included HPV vaccination in their national immunisation programs. As of 2021, 133 countries (50 (37.59%) HICs and 83 (62.41%) LMICs)) implemented CC screening programs. Most of these were in Europe (41, 30.83%), Asia (32, 24.06%), and North America (20, 15.04%). Additionally, 126 countries (44 (34.92%) HICs and 82 (65.08%) LMICs)) had published national guidelines on CC management. These countries were primarily in Asia (32, 25.40%) and Europe (32, 25.40%). Furthermore, 69 countries provided palliative care under both scenarios. The 10 countries with the highest annual opioid consumption (excluding methadone) for CC, in oral morphine equivalence per capita (2017), were all HICs. CONCLUSIONS:Major inequalities persist in CC vaccination and screening across 194 countries, and access to these services is limited in most LMICs. Focusing on vulnerable populations with lower incomes and regions with stunted economic growth may help alleviate inequity and accelerate CC elimination. We also found that tertiary prevention was achieved in most LMICs, but the indicator-reported annual opioid consumption in oral morphine equivalents indirectly illustrates the under-utilisation of cancer treatment services.

Objective To systematically investigate the key determinants influencing health information quality in social media environments and elucidate their hierarchical relationships, thereby providing evidence-based guidance for quality improvement. Methods This study employed an innovative integration of meta-ethnography and Decision-Making Trial and Evaluation Laboratory-Interpretive Structural Modeling (DEMATEL-ISM) methodologies. Through systematic extraction and multi-dimensional analysis of influencing factors—including centrality metrics, causal relationships, and hierarchical structures—we developed a comprehensive mechanism model clarifying factor interactions and their cumulative impacts on health information quality enhancement. Results Our analysis identified 18 critical factors affecting health information quality, which were categorized into six distinct hierarchical levels through rigorous computational modeling. The results revealed complex cross-level interactions and mutual influences among these determinants. Nine core factors emerged as pivotal: information accuracy, authority orientation, platform reputation, creator expertise, information utility, health information literacy, content originality, source authority, and health concepts. Conclusion The findings establish a hierarchical quality improvement framework, suggesting that targeted interventions focusing on the nine core factors can significantly enhance health information quality in social media ecosystems. This study provides both theoretical foundations and practical insights for multi-stakeholder collaborative governance in digital health communication.

BackgroundIn the context of oropharyngeal cancer poised to impose a significant disease burden, this study conducted an economic evaluation of HPV vaccination in Chinese male adolescents for the prevention of HPV-positive oropharyngeal cancer (OPC-HPV+), by constructing a multi-state Markov model from the societal perspective.MethodsThe model estimated the cost, effectiveness, and health utility of the bivalent, quadrivalent, and nonavalent HPV vaccines in preventing OPC-HPV+. Incremental cost-utility ratio (ICUR) was used to evaluate the economic viability of the vaccination strategies. One-way sensitivity analysis and probabilistic sensitivity analysis were employed to assess the model’s stability.ResultsAt a vaccine coverage rate of 70%, the incremental cost-effectiveness ratios of the bivalent, quadrivalent, and nonavalent vaccines were all lower than the per capita GDP compared to no vaccination, indicating that the vaccination strategies are highly cost-effective. The nonavalent vaccine has the highest incremental cost-effectiveness ratio, at 64,913.42 yuan ($9,211.86)/QALY. This strategy also has the highest cost, at 112.34 billion yuan, but it provides the best protection outcomes, preventing 2,545,988 cases of persistent HPV infection, 31,186 cases of OPC-HPV+, and 15,138 deaths, saving a total of 2,641,783 QALYs. Sensitivity analysis indicates that the discount rate, vaccine efficacy, HPV infection rate in the general population, and the probability of spontaneous clearance are the main factors affecting the pairwise comparison results of the strategies, which may lead to instability in the cost-effectiveness of the nonavalent vaccine.ConclusionHPV vaccination for male adolescents to prevent oropharyngeal cancer is cost-effective compared to no vaccination. China could expand the coverage of the appropriate-priced HPV vaccine to male adolescents in order to reduce the incidence of oropharyngeal cancer, improve male health quality, and protect public health.

Objective: To study the differences in the quality of elderly services in various regions of China, and to provide reference for the high-quality development of elderly services in various regions; Method: Combining the existing research results, using the entropy weight-rank sum ratio method, optimizing the evaluation system of the quality of elderly services in China, analyzing the empirical data on the effectiveness of elderly services in 31 provinces and municipalities (autonomous regions) in China from three aspects: economic status, medical level and social security, and The results: most of the regions with the highest economic ranking also rank high in terms of the quality of elderly services; the majority of regions have significant differences between the level of medical care and the quality of elderly services; social security has a greater impact on the quality of elderly services, with 85% of the regions having a similar level of social security and the quality of elderly services; Conclusion: The economy should be steadily developed to increase the content of regional elderly care resources; medical services should be closely adapted to the current situation of regional elderly care to promote the progress of elderly care services; social security should be comprehensively improved to provide multiple support for elderly care services. It is suggested that the economic policy should be reasonably regulated, the supply of quality medical resources should be increased, the construction of elderly service infrastructure should be accelerated, and talents for elderly service should be cultivated to promote the high-quality development of elderly service in China.

Objectives : This study mainly discusses the developing status in the field of health policy in recent two decades to provide an effective reference for researchers. Methods : Health policy publications published in Web of Science between 2011 to 2020 were searched, screened, organized, and analyzed the yearly-outputs, research author, institution, regional distribution, keywords, subject categories, and so on. Results: The total number of publications in health policy has shown a trend of upward in the past twenty years. Health policy was identified as the most productive journal. The research of United States takes the lead in this field. Health care, public health, epidemiology, children, and quality of life will likely to take a dominant position in future research. Conclusion : The field of health policy has developed a stable research community with good partnerships, and the high-impact authors lead the development of the discipline . The hotspots of health policy research are constantly updated with the trend of social development and have strong timeliness . With constantly study, health policy has become a relatively mature research topic, but it doesn't mean the termination of the study. It remains to be properly explored and improved to protect people’s health and promote the quality of life in the future.

Background: Precision medicine provides medical solutions to stratified patients with personalised forecasting outcome as an important method of treatment in the medical field. This study aims at delivering a structured overview to carry out a bibliometric analysis of precision medicine retrospectively. Methods: The compilation of data and the use of bibliometric methods based on academic databases (Science Citation Index-Expanded and PubMed) from January 1, 2010, to December 31, 2019. Research outputs, countries, institutions, authors, major journals, cited papers, hot subject areas were analysed. Results: 8,566 papers related were identified (98.728% in English) covering 1,975 different journals. The papers were originated from 109 countries; the USA held the predominant contributors with 4,635 papers, China was on second with 925 papers. Conclusions: Precision medicine serves important purposes in clinical treatment, and widely used in the oncology, biochemistry, molecular biology field. The study summarised existing work and provided guidance for future research in this promising precision medicine area.