Global health researchers at DKU are investigating how to reduce the economic burden of chronic diseases for rural elderly patients
By DKU Staff
Global health scientists at Duke Kunshan have teamed up with Duke University’s Common Cents Lab (CCL) to create a co-learning network in China supporting research into interventions that can help families improve their financial security.
The CCL, supported by MetLife Foundation, is an applied financial-behavior research lab established in 2016 as part of the Center for Advanced Hindsight. Its projects have positively affected nearly 500,000 low- to moderate-income individuals in the United States.
In association with Duke Kunshan, the co-learning network will provide funding and other support to three research projects a year in China to explore solutions aimed at improving financial wellbeing by increasing earnings, decreasing debt and managing cash flow, and to expand knowledge in the field of applied behavioral sciences.
“Many factors can impact a family’s finances, but we find that people often do not do things that are in their own best interest,” said Lijing L. Yan, associate professor of global health at Duke Kunshan. “The network is exploring how we can help households take the important steps to enroll in programs to reduce health costs, help migrant workers stay with employment long enough to reach their financial goals, and connect women in rural areas with available job opportunities.”
Yan is leading one of the network’s inaugural projects, an investigation into reducing the economic burden of chronic diseases for rural elderly patients by increasing awareness and take-up of China’s cost reimbursement system.
Health care expenses can be a major burden for Chinese families, particularly rural households. To tackle the issue, China added 70 new drugs – including 14 for chronic diseases – to the list of medicines covered by its national medical insurance program on Jan. 1, 2020, cutting the cost by up to 80 percent.
“Reducing the price of the medicine means patients save money, and yet many patients are not taking advantage of this reimbursement system because they haven’t been informed of this scheme or they aren’t filling their medication at qualifying pharmacies,” said Duan Zhao, a research analyst at Duke Kunshan’s Global Health Research Center (GHRC) and part of the study team.
“We hypothesize that by working with village doctors and collecting data, we can design field-based interventions that increase the number of people who take advantage of this reimbursement system, which contributes to their family’s financial health,” he said.
The two other inaugural projects focus on China’s large population of migrant laborers.
Researchers at Shanghai’s Fudan University are exploring ways to help migrant workers increase their tenure at a job to help them reach their financial goals and increase financial stability. Meanwhile, experts from Peking University will explore the psychological mechanisms that help “left-behind women” – those living in rural areas while their partner works away – increase participation in the local economy by picking up available day-labor to gain a stable source of income.
Like most activities in 2020, domestic and international measures introduced to combat Covid-19 have affected research projects. To keep Duke Kunshan’s project on track, the global health team made a series of adjustments, including moving the study area from Xuzhou, Jiangsu province, to rural Nantong, about two hour’s drive from Kunshan.
“Covid-19 delayed our study plan by several months, but the pandemic also affected roll-out of the new reimbursement policy. Nantong has just begun implementing its system, so the timing is perfect. We expect to finish the current project in time for next summer,” Zhao said.
“Over the next two years, we’re looking forward to expanding the network to strengthen the financial well-being of Chinese residents through further research in applied behavioral science.”