JMIR Publications

ABSTRACT

Background:

From the SARS outbreak in 2003 to the COVID-19 pandemic in 2019, a series of reform measures and policies have been introduced from the central to the local level in China.

Objective:

This study aims to construct an uncertainty index that reflects the volatility, risk, and policy characteristics of the health environment, which can serve as a reference for macroeconomic regulation and control by policymakers, provide environmental contextual support for studies such as hospital and resident behavior at the micro level, and provide a reference for countries that may face the same health policy uncertainty.

Methods:

Using the Wisenews database, 11 of the most influential newspapers in mainland China were selected to obtain the sample articles. The health policy uncertainty(HPU) index for each month from 2003-2022 was constructed by searching articles containing the specified keywords. Robustness tests were conducted through correlation analysis. The HPU index was plotted using STATA 16.0, and then a comparative analysis of the China and US HPU indexes was performed.

Results:

The China HPU Index was constructed and the robustness test showed a correlation coefficient greater than 0.74, which indicates good robustness. Key health events can cause index fluctuations. In December 2022, China's HPU index reached its highest value after the release of the "New Ten Rules" pandemic prevention and control policy.

Conclusions:

The HPU index is reasonable and can reflect the health policy uncertainty in China. Changes in critical health policies, major national or international events, and infectious diseases with widespread impact can cause fluctuations in the HPU index. In particular, the "New Ten Rules" policy released in December 2022 has brought China's health policy uncertainty to a peak. There were significant differences in HPU index fluctuations between the China and US during SARS and COVID-19, as well as during the Affordable Care Act.