Scope: overall mortality and money. After a chronic diagnosis you often still have decades ahead; this section is about how to manage those decades.
English, Russian and Spanish use dlgrv’s unofficial translations. Newly revised entries appear in the Chinese original until a checked translation is available. The author’s latest Chinese text is authoritative. Translation revision: dlgrv/HowToLiveBetter · b25fa8a
People who take their medicines as prescribed die less often than people who take them intermittently. Interpret this difference cautiously. Even people who consistently take a placebo have lower mortality, suggesting that some benefit comes from adherent people already paying more attention to their health.
Cost
There’s no cost at all;
Benefit
A meta-analysis pooled 21 studies with 46847 participants. Compared with people taking medication intermittent…
Hypertension, diabetes, outpatient chemo or radiotherapy for a malignant tumor, dialysis for uremia, and anti-rejection treatment after an organ transplant: for these, outpatient care away from home can in most cases be paid directly by insurance. You do not pay first and then claim it back where you are insured. You must first get outpatient chronic special-disease certification where you are insured, then file for care away from home. It works only if both are done.
Cost
No cost at all. You can complete the cross-regional medica…
Benefit
According to official documents from the National Healthcare Security Administration, this system is now large…
Chronic disease is about change over a stretch of time, not a single reading. Measuring blood pressure at home alone does not show the pressure coming down because of that. Bring the readings to the doctor and let the doctor adjust the drugs from them, and the pressure falls more. When you change hospitals, test results marked for mutual recognition are ones the hospital generally should not make you repeat.
Cost
Each checkup costs anywhere from a few dozen to several hu…
For cancers that can be cured, the risk of death for people who only use alternative therapies and do not receive conventional treatment is 2.5 times that of those who receive conventional treatment. People who use complementary therapies along with treatment are more likely to refuse surgery, chemotherapy, and radiation, and this is where the excess deaths come from. Some herbs (such as Hypericum perforatum) can also weaken the effect of anti-rejection drugs and anticoagulants. If you want to take them, ask your doctor first.
Cost
No cost at all;
Benefit
Two studies from US cancer registries examined nonmetastatic, potentially treatable breast, prostate, lung and…
If the illness is stable and the drugs have not been changed, a community health service center can prescribe at most 12 weeks of medicine at a single visit. That saves the half-day each month spent going to a large hospital, queuing, and registering.
Cost
There is no cost involved. Simply ask at your local commun…
Benefit
Patients no longer need to make monthly trips to larger hospitals just to obtain prescriptions. In the same in…
The standard package of basic services is covered by yibao as required. Any customized service packages must be paid for entirely by the patient. When someone offers an “upgrade package,” be sure to ask whether it’s a basic or customized package, whether it’s officially registered, and how much it costs per year.
Cost
There’s no cost involved. Asking a few questions before yo…
Benefit
The basic service package is paid for by yibao per regulations. Customized packages require full out‑of‑pocket…
Diabetes can damage both the retina and feet, but there are almost no noticeable symptoms until the damage becomes severe enough to cause vision loss or foot ulcers. Early detection makes treatment possible. For type 2 diabetes, a dilated eye exam should be done right after diagnosis; for type 1 diabetes, it’s recommended to start five years after onset. If previous tests showed no issues and blood sugar levels remain well-controlled, the interval can be extended to once every one or two years. Foot checks should be done annually.
Cost
A single dilated eye exam costs anywhere from a few dozen…
Benefit
Retinal damage caused by diabetes is known as diabetic retinopathy, while damage to the feet is called diabeti…
Among people who grew a first calcium stone and no cause was found, about a quarter grow another within 5 years if they do nothing. Among people who drink at least 2 liters of water every day, a bit over a tenth have a recurrence within 5 years, fewer by more than half. The British guideline gives 2.5 to 3 liters of water a day, and salt no more than 6 grams.
Cost
There is no cost at all. Simply make drinking water a dail…
Benefit
A 5-year randomized controlled trial in 199 patients with a first calcium stone and no cause found (also calle…
If you have tophi, gout-related bone damage or 2 or more flares a year, take urate-lowering medication long term and keep urate below 360 µmol/L. If flares are infrequent, discuss whether medication is appropriate with your doctor. In a trial with nurse-led adjustment based on test results, 95% reached target at 2 years versus 30% with usual care. Most people who stopped medication after good control had another flare within 5 years; dietary restriction lowers urate only to a limited extent.
Cost
Allopurinol costs only a few to several tens of yuan per m…
Benefit
A randomized controlled trial of 517 adults who had flared in the past 12 months. The nurse-led group had the…
Among people who have had gout, higher purine intake over the preceding 2 days is associated with more flares, with the highest-intake group most affected. This also holds among those taking urate-lowering drugs. Drinking 2–4 alcoholic drinks the day before is also linked to more flares, whether beer, spirits or wine.
Cost
No cost. At a barbecue or a group meal, order fewer meat s…
Benefit
A study followed 633 gout patients online for 1 year, comparing a pair of days before each person's flare with…
People who carry hepatitis B virus, checked every half year with ultrasound and alpha-fetoprotein, had nearly 40% fewer deaths from liver cancer in a Shanghai trial. The more virus in the blood, the more liver cancer later. People whose liver was already badly fibrotic or cirrhotic, once on an antiviral, had about half as much liver cancer. Most of these drugs have to be taken long term; if you stop on your own the virus readily rebounds.
Cost
Go to hepatology or infectious disease every half year, ha…
Benefit
A randomized trial in Shanghai of 18816 people aged 35 to 59, all infected with hepatitis B virus or with a hi…
Among people who use an inhaler, only about 30% get the technique fully right, and some errors keep the drug from reaching the lungs. Patients who made a critical error had about twice the share admitted or seen in emergency for an exacerbation. After hospitalization for an acute exacerbation, pulmonary rehabilitation is performed, and significantly fewer patients are hospitalized again, and the quality of life and walking ability will be better. Whether it means fewer deaths is not yet clear.
Cost
Having the inhaler technique watched costs nothing extra.…
Benefit
A national sample survey in China gave lung-function tests to 50991 adults aged 20 and over. The share with CO…
Among adults in China with chronic kidney disease, only about a tenth know they have it. Yearly urine and blood tests can find kidney disease earlier in type 2 diabetes, and in type 1 diabetes once the disease has lasted 5 years. For people found to have elevated urinary protein, a medicine such as dapagliflozin lowers the combined risk of worsening kidney function, dialysis or death by about 40%, and the risk of death by about 30%.
Cost
Give a urine sample for the urine albumin-to-creatinine ra…
Benefit
China's national chronic-disease surveillance for 2018 to 2019 tested blood and urine in 176874 adults. About…
After surgery and chemotherapy for colon cancer, a 3-year supervised exercise program lowered the risk of recurrence, a new cancer or death by about 28%, and the risk of death by about 37%. At 8 years, about 90% of the exercise group were alive, versus about 83% of those receiving only health pamphlets. Muscle and joint injuries were more common with exercise.
Cost
Walking and similar exercise cost nothing. An assessment a…
Benefit
A randomized trial at 55 centers (CHALLENGE) enrolled 889 people with colon cancer. All had finished surgery a…
