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Objective:To study the status quo of National Essential Medicine System ( NEMS) in village clinics of a province in western China. Methods:Individual in-depth interview was carried out with village doctors and their managers of a province in western China, to understand the subsidies of zero-markup rate, compensations for general medical fees, and status quo of NEMS assessment mechanism and its impacts on prescribing behavior of village doc-tors. Results:In the surveyed area, the intervention of NEMS has not achieved the desired objectives: the prescri-bing behavior of village doctors has not changed significantly;general medical fee system has failed to achieve reason-able compensations;and the assessment mechanism done by village doctor managers has been a mere formality. Con-clusions and Suggestions:To ensure the feasibility, effectiveness and sustainability of the intervention, the area poli-cymakers should take into full consideration the special nature of village doctors.
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Objective:To explore trends in health care need and utilization among China’s aged population and provide a reference for policy-making on medical service provision for the aging population. Methods:The paper ana-lyzes prevalence, outpatient utilization, hospitalization, and medical expenses of the aging population using large comparable sample data from National Health Services Survey in 1998 , 2003 and 2008 . Results: From 1998 to 2008 , the two-week prevalence rate ranged from 29 . 0% to 43 . 2%; the prevalence rate of chronic diseases ranged from 50 . 2% to 59 . 5%; the two-week visiting rate ranged from 31 . 7% to 28 . 3%; and the hospitalization rate ranged from 7 . 9% to 13 . 8%. Conclusion:Chronic diseases have been the major health issues of the aging popula-tion. The financial burden greatly reduces the utilization of medical care among the aged population. A health system that can respond to the aged population quickly is much needed.
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Objective:To describe the status of self-rated health(SRH)among the elderly and find out the relationship between SRH and other health measures such as two weeks prevalence and chronic disease prevalence.Methods:The data used was generated from cross-sectional household health survey conducted in the year of 2009 in Shunyi district,Beijing.SPSS software was used to conduct univariate and multivariate liner regression analysis with self-rated health.Results:The average score of self-rated health among the elderly is 72.49.Univariate analyses suggest that are age,sex,marital status,income level,education,employment,medical insurance type,self-perceived anxious or depression,disease state are all associated with poor SRH score.Multiple liner regression model shows that age,job,medical insurance,self-perceived anxious or depression,suffer from two-week illness and chronic disease had effects on SRH of the elderly.Conclusion:Physical and psychological unhealthy are independent risk factors of SRH among the elderly,disease status is the most influential predictor on SRH score.Thus,a single measurement of SRH question can be used in health status assessment of the elderly.
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Objective:To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients,gathering evidence to improve the doctor-patient relationship.Methods:This study was a cross-sectional study,in which doctors and nurses in 10 hospitals of Beijing,Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews.Results:The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97,which was much lower than the patients'.The patients' socio-demographic characteristics,social economic status(SES) and behavior characteristics influence the interaction of the doctors and the patients.The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust.Conclusion:The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship.The patients' characteristics have important influence on the doctor-patient relationship.It's necessary to take action on the patients to improve the doctor-patient relationship.
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Objective To find out about the current situation of the for-profit hospitals in a Southern province and to compare them with the nonprofit hospitals there of the same size. Methods Using routine health statistics data of the year 2002,71 for-profit hospitals with authorized beds were compared with 132 nonprofit hospitals of the same size.Results The for-profit hospitals had a small number of staff and basically little burden posed by retired personnel;they provided a small volume of outpatient and emergency services but a volume of inpatient services equal to that provided by the nonprofit hospitals;their income and expenditure levels were less than half of those of the nonprofit hospitals,but they had a balanced budget;like the nonprofit hospitals,they faced the issue of patients defaulting on payment.Conclusion Now that the development of non-public economy is being encouraged in the country,for-profit hospitals will witness high growth.Thus possible adverse effects ought to be carefully taken into account in the formulation of policies and corresponding countermeasures ought to be taken.
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Contemporary management ideas and social movements have impelled governments and service providers to value healthcare consumers' opinions and experiences. Patient satisfaction surveys have been used as a routine tool to measure a hospital's service quality from the patient's angle and patients' fidelity towards service providers. Quality improvement measures and service development strategies are consequently formulated. However, there still exist many problems in the research on and use of satisfaction surveys as a measurement tool, including lack of strategies for scientific tool selection and development, lack of standardization and analysis benchmarking, emphasis on nursing service at the expense of a hospital's overall service quality, lack of psychological surveying and research on applicability and practicability, artificially introduced bias factors in conducting the surveys, oversimplified presentation of survey results, and limited use of information, It is suggested that guidelines for tool selection and development be formulated, regional or nationwide benchmarking be established, plan designs in conducting the surveys be perfected, presentation of survey results be improved, and rational use of information be promoted.
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Objective To find out about the development of nongovernmental medical services in China as well as the appraisals of such services by various quarters so as to provide basis for the formulation of policies for their management and development. Methods Cross-sectional studies were made in the provinces of Guangdong, Shanxi and Sichuan. By means of questionnaires and interviews, appraisals of nongovernmental medical services by residents, physicians, managers of medical institutions, investors of nongovernmental medical institutions and managers from the administrative departments of health were collected and differences in the appraisals made by people representing various interest groups were analyzed. Results Over 30% of the residents make use of nongovernmental medical services and appraisals of them surpass those of public medical services. Nongovernmental medical institutions have both advantages and disadvantages, with unfair social treatment being the major obstacle to their development. Conclusion Since nongovernmental medical services have already taken an important position in the setup of medical services of China, efforts should be made to coordinate relevant policies so as to bring their role into greater play.