15 November 2025, Volume 39 Issue 11
    

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  • Study on the satisfaction of urban residents with primary healthcare services and its influencing factors based on Anderson model
    XU Mengqun, LI Xi, LI Xiuling, CHEN Taihao, WANG Qun, PENG Xiaowei, CHEN Siyin, ZHANG Jiangping
    Soft Science of Health. 2025, 39(11): 1-5. https://doi.org/10.3969/j.issn.1003-2800.2025.11.001
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    Objective To understand urban residents' satisfaction with primary healthcare services and its influencing factors, and to provide a reference for improving residents' satisfaction with primary healthcare services, promoting initial visits at primary medical institutions and tiered diagnosis and treatment. Methods Based on the Anderson model, this study employed convenience sampling to conduct questionnaire surveys among residents in Yunyan District, Guiyang City. Chi-square tests and binary logistic regression models were used to analyze urban residents' satisfaction with primary healthcare services and its influencing factors. Results The overall satisfaction rate of primary healthcare services among the respondents was 81.76%. Demand-side factors of residents: age, household registration, the level of awareness for primary healthcare institutions, annual household income, income source, the type of medical insurance, subjective evaluation for primary health services, and previous medical behaviors all had an impact on satisfaction (P<0.05). Supply-side factors of institutions: various dimensions of healthcare services, such as the medical environment, availability of drugs and equipment, the accessibility and timeliness of services, healthcare providers' attitudes during communication, and the quality of technical services, all had an impact on residents' satisfaction (P<0.05). The results of the multivariate binary logistic regression analysis revealed that those aged 60 and above, who had a high level of understanding of primary healthcare institutions, a household annual income of more than 30,000 yuan, a relatively good subjective evaluation on the utilization of primary health services, receiving medical services 1 to 3 times per month, excellent medical environment, good communication attitudes of medical staff, and receiving high-quality technical services reported higher satisfaction with primary healthcare services. Conclusions Urban residents' satisfaction with primary healthcare services in the study area is influenced by factors such as the respondents' age, household income, cognition, subjective evaluation on service utilization, and the process of healthcare services.
  • Research on the construction of actor networks in healthcare driven by artificial intelligence in the digital age
    LIU Shuangyuan, TU Zixuan, CHEN Sisi, SHEN Lining
    Soft Science of Health. 2025, 39(11): 6-14. https://doi.org/10.3969/j.issn.1003-2800.2025.11.002
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    Objective In response to the collaborative challenges faced by multiple actors in the healthcare industry in the digital era, this study analyzes the construction logic of actor networks in healthcare driven by artificial intelligence (AI) based on Actor-Network Theory (ANT) to provide theoretical support and practical paths for the digital transformation of the industry. Methods Based on ANT, an analytical framework that included human actors such as governments, medical and healthcare institutions, and patients, as well as non-human actors such as AI technology, medical data, and policy regulations was built. Through the translation process of “problem presentation-benefit assignment-recruitment mobilization-objection elimination”, the case of digital transformation of healthcare in Guiyang was combined to examine the key links in the construction of the actor networks. Results The study found that the construction of AI-driven actor networks needed to break through the traditional perspective of technical tools and regard AI as a “non-human actor” with motivation. The case showed that Guiyang has realized the optimization of medical resource allocation through the translation strategy. The error rate of vaccine inventory management has decreased, and there were 310,000 visits in the Internet health platform, which verified the interpretation of ANT for complex social and technical systems. Conclusions The effective construction of the actor networks in healthcare should not only transform the advantages of AI technology into specific solutions to address pain points in the industry, but also establish a mechanism for sharing benefits to ensure the continuous participation of multiple stakeholders. It has expanded the application of ANT in the field of digital health, facilitating the construction of a collaborative and efficient digital ecosystem for healthcare.
  • Research on cyberbullying detection based on machine learning
    HU Wanfei, DU Naixin, ZHANG Wei, ZHANG Jianwei
    Soft Science of Health. 2025, 39(11): 15-20. https://doi.org/10.3969/j.issn.1003-2800.2025.11.003
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    Objective This study aims to provide robust technical support for improving the governance system of cyberbullying and creating a harmonious online environment to facilitate the healthy development of cyberspace. Methods Ten hot events on Sina Weibo from July 2022 to January 2023 were selected. A web crawler of Python was used to obtain the comment texts and related data of Weibo posts related to these events. Based on the characteristics of texts, emotion and users, the Adaboost algorithm was used for experiments to test the effectiveness of cyberbullying detection. Results The duration of cyberbullying varied significantly for different events, but it mainly appeared in the early stage of the events. The accuracy, precision, recall, and F1 Score of the optimal results were 0.769, 0.758, 0.769 and 0.729 respectively. The results obtained without considering the users' characteristics were approximately 0.01 lower than the aforementioned optimal results. Conclusions Good results can be achieved in cyberbullying detection by combining three types of characteristics. Taking into account users' characteristics can improve the effectiveness of cyberbullying detection to some extent. Paying attention to the evolution of abusive language online or incorporating multi-dimensional information can further improve the effectiveness of detection, thereby strengthening the governance of cyberbullying information and creating a favorable online environment.
  • Study on the current situation and trends of burden of disease of malignant tumors in China in 2021
    JIN Xinyi, ZHONG Yuexin, ZHANG Yongfang, MA Shuang
    Soft Science of Health. 2025, 39(11): 21-25. https://doi.org/10.3969/j.issn.1003-2800.2025.11.004
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    Objective This paper analyzes the current situation and development trends of burden of disease of malignant tumors in China in 2021, and compares with the global data, in order to provide a reference for the prevention and treatment of malignant tumors in China. Methods Based on the data from the Global Burden of Disease in 2021 (GBD 2021), the Joinpoint log-linear model was applied to calculate the average annual percentage change in the incidence, mortality, and disability-adjusted life years (DALYs) of malignant tumors in different genders and age groups in China from 1990 to 2021. A Bayesian age-period-cohort model was built to predict the burden of disease from 2022 to 2035. Results From 1990 to 2021, the standardized incidence rates of malignant tumors in China showed a significant increase and surpassed the global level. Meanwhile, the standardized mortality rates and standardized DALYs in China remained consistently higher than the global benchmark. At the gender level, burden of disease for men had always been significantly higher than that of women in China, and the gender disparity was greater than that in the global context. At the age level, the relevant indicators in China have been continuously increasing with age. The older adults bore the most significant burden of disease. The incidence of malignant tumors showed a trend of becoming more common among young people. From 2022 to 2035, China's standardized incidence rates were projected to keep rising, while the standardized mortality rates and the standardized DALYs declined. The global trend remained downward. Conclusions China has achieved phased results in the prevention and treatment of malignant tumors, but the overall prevention and control situation still faces major challenges. The standardized incidence rate, standardized mortality rate and standardized DALYs of malignant tumors in China are all higher than the global average. Moreover, the standardized incidence rate is expected to continue to increase, and the burden of disease on the older adults and men is heavy.
  • Construction and empirical research on an evaluation index system of the attractiveness for high-level talents in public hospitals of non-central cities from the perspective of amenity theory
    QIN Qiuyan, DING Xijun, CAO Haihong, WANG Wei, HU Dejian
    Soft Science of Health. 2025, 39(11): 26-30. https://doi.org/10.3969/j.issn.1003-2800.2025.11.005
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    Objective To establish an evaluation index system of the attractiveness for high-level talents in public hospitals of non-central cities, thereby providing a reference for quantifying the level of attractiveness for high-level talents in hospitals. Methods Based on the amenity theory, the evaluation indicator pool was constructed by literature review and expert interviews. The final evaluation indicators for attractiveness were determined through the Delphi expert consultation method. The analytic hierarchy process was used to calculate the weights of each evaluation indicator. A questionnaire survey was used to evaluate the attractiveness of high-level talents in five public hospitals of Weifang City, verifying the scientific validity, reliability and stability of the evaluation index system. Results The evaluation index system included five first-level indicators: urban factors, hospital strength, salary and benefits, discipline development, and talent services. The rankings of evaluation on attractiveness for the five public hospitals in Weifang City with multiple statistical methods were consistent. Conclusions This evaluation index system can be used for the quantitative assessment of the attractiveness for high-level talents in public hospitals in non-central cities. It provides a policy-making basis for public hospitals to address challenges of high-level talent recruitment in non-central cities. It also can assist high-level talents in accurately evaluating the comprehensive attractiveness of target hospitals when seeking employment and making career choices that align with their personal needs.
  • Research on the impact of multiple institutional logics on the effectiveness of home-based and community-based integration of medical and elderly care services
    GU Dandan, ZHANG Jiawen, LU Fang
    Soft Science of Health. 2025, 39(11): 31-36. https://doi.org/10.3969/j.issn.1003-2800.2025.11.006
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    Objective To explore the influence mechanism of multiple institutional logics on the effectiveness of home-based and community-based integration of medical and elderly care services. Methods A questionnaire survey was conducted among older adults receiving home-based and community-based integration of medical and elderly care services or their family members. SPSS and Amos software were used to construct a structural equation modeling (SEM) to examine the main effects and interaction effects of multiple institutional logics on the effectiveness of home-based and community-based integration of medical and elderly care services. Results The multiple institutional logics, government logic, market logic, and family logic respectively had a significant positive impact on integration effectiveness, while the two-way interactions between these logics showed a significant negative impact on integration effectiveness. Conclusions The main effects and interaction effects of multiple institutional logics have an impact on the effectiveness of home-based and community-based integration of medical and elderly care services. It is necessary to recognize the core tenets of each institutional logic and promote the compatibility and coordinated development of multiple institutional logics.
  • Empirical study on home-based and community-based integration of medical and elderly care services from the perspective of supply-demand matching theory
    ZHANG Jiawen, GU Dandan, LU Fang
    Soft Science of Health. 2025, 39(11): 37-43. https://doi.org/10.3969/j.issn.1003-2800.2025.11.007
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    Objective Based on the theory of supply and demand matching, an empirical analysis was conducted to examine the level of supply-demand matching for home-based and community-based integration of medical and elderly care services in Nanjing. This analysis systematically reveals the structural contradictions and group differences, and proposes a systematic optimized path. Methods A cross-sectional survey was conducted among 98 healthcare workers and 243 older adults from five community health service centers in Qinhuai District, Nanjing. An innovative supply-demand matching model (including the matching degree and matching environment) was employed to quantitatively measure the supply-demand matching levels of 14 items within four categories of services, namely basic care, health management, home visit services, and spiritual comfort services. Results The overall supply was a shortage. The matching environment values for all four types of services were 1, and the total supply was lower than the demand. Service structure was imbalanced. The matching degree of health management services was the highest (0.9858), whereas home visit services (0.9539) and spiritual comfort services (0.9549) showed significantly lower levels. Excretion care (0.9483) and psychological support (0.9446) were the most critical deficiencies. Pronounced group disparities were observed. Vulnerable service recipients such as the disabled, those with low income, and older adults were subject to multiple forms of service exclusion. Conclusions Home-based and community-based integration of medical and elderly care services encounter three major contradictions: insufficient total volume, structural mismatch, and imbalance among different groups. A systematic optimization was needed from three dimensions: institutional design, systemic collaboration, and precise policy implementation. It is necessary to establish a dynamic monitoring and hierarchical response mechanism, promote the integration and intelligent empowerment of medical care and elderly care resources, and strengthen the synergistic support of long-term care insurance and social assistance to enhance the adaptability and equity of services
  • Legal protection of traditional Chinese medicine knowledge in China — legislation based on the Regulations on the Protection of Traditional Chinese Medicine Knowledge
    LONG Wei
    Soft Science of Health. 2025, 39(11): 44-50. https://doi.org/10.3969/j.issn.1003-2800.2025.11.008
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    This article summarizes the existing legislative framework and protection status of traditional Chinese medicine (TCM) knowledge in China. It is found that the protection of TCM knowledge is composed of a specialized law framework, an intellectual property law framework and an international framework. However, these protection methods have certain deficiencies or limitations in aspects such as the defensive protection of TCM knowledge, the standardization of the operation mechanism of the rights of the holders, the appropriateness of the restrictions on the rights of the holders, and the connection with the current legal system. Suggestions have been put forward, including improving the defensive protection mechanism for TCM knowledge, standardizing the construction of the rights system for holders, perfecting the balance mechanism between the interests of holders and public interests, and effectively connecting with the current protection system.
  • Replacing the alienation of patient's right to self-determination with “the involvement of close relatives” — reflections and reconstruction for protective medicine system in China
    CHEN Lulu, ZHANG Jing
    Soft Science of Health. 2025, 39(11): 51-55. https://doi.org/10.3969/j.issn.1003-2800.2025.11.009
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    This study employs methods such as literature review, case studies, empirical research and comparative study to deeply analyze and research the essence of protective medicine in China and existing problems in contemporary society. The research finds that close relatives' substitute decision-making has the following problems: ambiguous applicable standards for substitute decision-making of close relatives, inadequate restrictions on the substitute decision-making rights of close relatives, and unsatisfactory effect of close relatives' substitute decision-making. By analyzing international relevant experiences of therapeutic privilege, the paper proposes suggestions for reconstructing protective medicine system in China from three aspects: restoring the patients' right to self-determination, transforming the transmittal mode of medical information, and enhancing the role of close relatives in assisting decision-making.
  • Predicaments and solutions of grassroots health governance in China from the perspective of platform organizations
    HUANG Shusheng, YIN Aitian, LI Ying
    Soft Science of Health. 2025, 39(11): 56-61. https://doi.org/10.3969/j.issn.1003-2800.2025.11.010
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    The equalization of grassroots health services is one of the key of China's new round of healthcare system reform, and the grassroots health governance system is the core mechanism to ensure the equalization of grassroots health services. From the perspective of governance, grassroots health governance in China still faces complex endogenous challenges such as the lack of a deep consensus on the concept of whole-life cycle of health services, difficulties in stimulating systematic dynamics within the vertical management system, fragmented health services information, and the poor policy alignment of healthcare. Based on platform organizations theory, this paper conducts an exploratory study on the construction of a grassroots health services platform, and builds a theoretical framework of “frontend + middle platform + backend + ecosystem”. Through the task-implementation-oriented frontend of the health service platform, the intelligent service-empowering middle platform, and the backend of controlling that aggregates core resources, a health service ecosystem characterized by unified value, information sharing, capability integration, and action coordination is formed ultimately, thereby promoting the enhancement of the governance efficiency of grassroots health services.
  • Regional differences, dynamic evolution and convergence of TCM development index in China
    TIAN Na, ZHANG Li, CAI Hongfei, LI Qiushi, WANG Junyong, ZHANG Delin
    Soft Science of Health. 2025, 39(11): 62-68. https://doi.org/10.3969/j.issn.1003-2800.2025.11.011
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    Objective To explore the establishment of a provincial TCM development index in China and analyze its regional differences, spatial and temporal evolution and convergence, and to provide a basis for formulating differentiated development policies. Methods The panel data of 31 provincial administrative regions in China from 2012 to 2022 were used to establish the TCM development index from two dimensions of TCM industry and TCM cause. The regional differences, dynamic evolution and convergence of the TCM development index were measured respectively by the decomposition of the Gini coefficient, Kernel Density Estimation and Markov chain. Results The average level of TCM development index in China has shown a trend of increasing year by year. There were significant regional differences among provinces, showing obvious spatial non-equilibrium characteristics. The disparity in intensity of transvariation was the primary cause of regional differences in the development of TCM. Kernel Density Estimation showed that the regional differences in the development of TCM were expanding, and the three major regions (east, central, and west) showed different performances. Markov chain analysis showed that with the continuous development of social economy, the number of provinces at the medium and low development levels would decrease, while the number of provinces at the medium and high levels would increase. Conclusions The development level of TCM has gradually improved, but regional differences still exist. The spatial non-equilibrium fluctuations increase and intensity of transvariation is the primary cause of regional differences in the development of TCM. Regional disparities may gradually widen, and regional synergy is an important task for the development of TCM. The principle of gradual development should be followed, and a high-level regional balance should be achieved step by step.
  • Evaluation of economic losses of healthcare-associated infections in a certain traditional Chinese medicine hospital based on propensity score matching
    JIANG Dongxian, YAN Ruoxin, LI Yun, GUO Zhuying, WU Xuan, XIE Yi, LAN Zhiming
    Soft Science of Health. 2025, 39(11): 69-74. https://doi.org/10.3969/j.issn.1003-2800.2025.11.012
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    Objective This paper explores the economic burden of inpatients with healthcare-associated infections (HAIs) to provide a reference for the rational allocation of limited healthcare resources. Methods Medical records of 32,762 inpatients in a Grade-A tertiary traditional Chinese medicine hospital in Guangdong Province from January to December 2022 were retrospectively reviewed. Propensity score matching was used for 1∶1 pairing. Marginal analysis was applied to assess the economic losses imposed by HAIs to inpatients and the hospital. Results In 2022, there were a total of 175 cases of HAIs in the hospital, with an infection rate of 0.53%. Propensity score matching was successfully applied to match 175 pairs of patients. Patients with HAIs led to an average increase of 41,617.27 yuan in total costs (P<0.001). The increased costs mainly came from the expenses for western medicine, laboratory tests, and traditional Chinese medicine treatments (P<0.05). Patients with HAIs led to an average increase of 16 days in the length of hospital stay (P<0.001). The economic loss of the hospital due to HAIs was approximately 321,900 yuan (M%=5%), with a loss-profit ratio of 1.20% and a coefficient of 2.26 between the loss-profit ratio and the infection rate. Conclusions HAIs impose a significant economic burden on both inpatients and the hospital.
  • The current situation, problems and development trends of unified planning of basic medical insurance at the provincial level in China
    LI Yuting, SONG Yan
    Soft Science of Health. 2025, 39(11): 75-80. https://doi.org/10.3969/j.issn.1003-2800.2025.11.013
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    Objective By analyzing the current status, deficiencies and development trends of the unified planning policies of basic medical insurance at the provincial level in typical provinces, this paper proposes policy suggestions for promoting the unified planning of basic medical insurance at the provincial level. Methods Policy texts on the unified planning of basic medical insurance at the provincial level from various provinces were collected. Policy analysis and case study were employed to conduct a content analysis of the specific implementation of each province. In-depth interviews with some managers from medical insurance departments were carried out to gain insights into the current practices, progress and existing shortcomings in the unified planning at the provincial level. Results As of May 2025, 17 regions in China have implemented unified planning at the provincial level. Each area implementing unified planning has adopted unified planning models that suited their local conditions and has formed three typical models: unified revenue and expenditure + vertical management, unified revenue and expenditure + hierarchical management, and risk-adjusted funds + hierarchical management. Moreover, a risk shared responsibility mechanism, performance assessment mechanism, operation management system, and related supporting measures have been established. However, it still faced challenges such as inconsistent policy standards, unified planning models that required further optimization, relatively lagging supporting measures, and increased moral hazard. Conclusions Unified planning policies of basic medical insurance at the provincial level have achieved significant progress, but there are still some structural problems such as policy fragmentation and regional imbalance of funds. It is recommended to further improve the institutional framework, optimize the unified planning models, strengthen information construction, prevent moral hazard, and promote balanced allocation of funds.
  • Evaluation of the effectiveness of policies for childhood obesity prevention — a dynamic tracking study based on machine learning models
    LIN Tianwu, ZHU Zhenzhen, WU Changhong, CHEN Xi, YUAN Xiaojuan, CHEN Shichen, ZOU Chunli, WU Liqun
    Soft Science of Health. 2025, 39(11): 81-87. https://doi.org/10.3969/j.issn.1003-2800.2025.11.014
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    Objective To evaluate the dynamic evolution of influencing factors and the effectiveness of the policy of “one physical education class per day in the compulsory education stage” implemented in Shenzhen in 2024 on the childhood obesity prevention, and to provide a reference for the precision of policies for childhood obesity prevention. Methods The physical examination data of primary school students in Yantian District, Shenzhen City from 2022 to 2024, cross-sectional samples (14,945 people in 2022, 15,234 people in 2023, and 15,408 people in 2024) were used for feature importance analysis. Subsequently, data from three consecutive years were matched to construct a tracking cohort (n=9,521) for policy effectiveness evaluation. Models such as XGBoost and random forests were employed to assess the importance of factors such as gender, age, grade, and dental caries with SHAP values. Linear double machine learning was used to estimate the conditional average treatment effect (CATE) of the policy on the deviation of BMI-for-age Z-score (BAZ) with controlling for confounding factors. Results Gender remained the primary influencing factor (with a contribution rate of 47.4% to 52.2%), and males had a higher risk of being overweight. After the implementation of the policy, the contribution rate of age decreased (from 22.6% to 19.5%), while the contribution rate of dental caries increased (from 5.8% to 16.4%). Although the prevalence of dental caries significantly declined (88.7% in 2022 and 54.5% in 2024, P<0.001), its predictive value strengthened. The policy effect evaluation showed that after the policy implementation, CATE of the deviation of BAZ was 0.210 (95%CI: 0.035~0.384, P=0.035). The overweight rate increased from 28.0% to 32.5% (P<0.001), and the negative effect in grades intensified (-0.055→-0.066). Conclusions The increase of frequency of physical education classes has failed to effectively curb the rising rate of childhood obesity, which might be influenced by factors such as implementation deviations and confounding diets. It is recommended to integrate exercise and dietary interventions, optimize the curriculum design, and expand multi-center studies to enhance the scientific validity of prevention strategies.
  • Study on the satisfaction of urban residents with primary healthcare services and its influencing factors based on Anderson model
    XU Mengqun, LI Xi, LI Xiuling, CHEN Taihao, WANG Qun, PENG Xiaowei, CHEN Siyin, ZHANG Jiangping
    Soft Science of Health. 2025, 39(11): 88-93. https://doi.org/10.3969/j.issn.1003-2800.2025.11.015
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    Objective To understand urban residents' satisfaction with primary healthcare services and its influencing factors, and to provide a reference for improving residents' satisfaction with primary healthcare services, promoting initial visits at primary medical institutions and tiered diagnosis and treatment. Methods Based on the Anderson model, this study employed convenience sampling to conduct questionnaire surveys among residents in Yunyan District, Guiyang City. Chi-square tests and binary logistic regression models were used to analyze urban residents' satisfaction with primary healthcare services and its influencing factors. Results The overall satisfaction rate of primary healthcare services among the respondents was 81.76%. Demand-side factors of residents: age, household registration, the level of awareness for primary healthcare institutions, annual household income, income source, the type of medical insurance, subjective evaluation for primary health services, and previous medical behaviors all had an impact on satisfaction (P<0.05). Supply-side factors of institutions: various dimensions of healthcare services, such as the medical environment, availability of drugs and equipment, the accessibility and timeliness of services, healthcare providers' attitudes during communication, and the quality of technical services, all had an impact on residents' satisfaction (P<0.05). The results of the multivariate binary logistic regression analysis revealed that those aged 60 and above, who had a high level of understanding of primary healthcare institutions, a household annual income of more than 30,000 yuan, a relatively good subjective evaluation on the utilization of primary health services, receiving medical services 1 to 4 times per month, excellent medical environment, good communication attitudes of medical staff, and receiving high-quality technical services reported higher satisfaction with primary healthcare services. Conclusions Urban residents' satisfaction with primary healthcare services in the study area is influenced by factors such as the respondents' age, household income, cognition, subjective evaluation on service utilization, and the process of healthcare services.
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