ABSTRACT
OBJECTIVE:To provide reference for the construction of suitable evaluation index system for the implementation of National Essential Medicine System in community health service center.METHODS:The frame of evaluation index system was designed by theoretical analysis,literature study and expert interviews methods.Delphi method was used to establish evaluation index system for National Essential Medicine System in Shanghai community health service center.Analytic hierarchy process was adopted to determine the weights of indicators at all levels.RESULTS:The positive coefficients of the two rounds consultations were 88.24％ (15/17) and 86.67％ (13/15).The authority coefficient of structural index,processing index and result index in the first round consultation were 0.68,0.68 and 0.69,respectively,which showed that the authority degree was higher.The coefficient of concordance in the second round consultation was higher than the first round (the indexes of structure,process and result in two rounds consultation were 0.286,0.306,0.193 and 0.345,0.358,0.337,respectively),which indicated the expert opinions were highly consistent.Established evaluation index system consisted of 3 fiust-level indexes,13 second-level indexes and 27 third-level indexes.CONCLUSIONS:The selected experts were representative,the consultation results were reliable,established evaluation index system was rational and the setting of weights was scientific.Also this study was a methodological exploration.
ABSTRACT
Objective To understand the comments for the essential drug system by doctors at township health centers in Nantong's six counties and to discuss the effect of implementing the essential drug system to different ownership systems.Methods The survey was made with stratified clusters random sampling method to select township health centers.Questionnaires were filled out by doctors,and leaders of the health bureau and township health centers were interviewed.Results After the implementation of the essential drug system,94.6％of the doctors found that the number of laboratory examinations increased in Rugao,Rudong and Haian.23.2％of the doctors in Tongzhou,Qidong and Haimen found that enthusiasm for work increased.Conclusion The compensation mechanism should be perfected and the financial subsidies should be paid in time.Supervision and management should be strengthened and the grassroots need for medicine be ensured.The skills training should be enhanced and the medical service ability be improved.
ABSTRACT
Objective: To analyze the influences of implementing essential medicine system on primary medical institutions and give suggestions. Methods: Using system dynamics method to construct the compensation mechanism model for primary medical institutions. Compare the growth in revenue and expenditure of primary medical institutions before and after essential medicine system implementation. Results: After the implement of essential medicine system, the growth in total expenditure and total income of primary medical institutions is steadier; when the annual growth rate of government financial subsidies invested more than 13%, the growth in total receipts will keep balance. Conclusion: It’s better to guarantee the government financial subsidies invested in time, raise medical service price properly and establish comprehensive compensation mechanism for implementing compensation mechanism of primary medical institutions.
ABSTRACT
This paper made systematic description of the three objectives of sustainable development designed for the policy based on the sustainability theory for the health sector.The essential drug system for secondary hospitals comprises the list coverage and allocation percentage of essential drugs,requirements for bidding and purchasing as well as pricing practice; management and conditions of these hospitals,including leadership determination and competency,doctors prescription behavior,and supportive reforms at these hospitals; external policies and social environment,including government financial subsidy,medical service prices adjustment,medical insurance,and the awareness and attitude of the people on essential drugs.
ABSTRACT
ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.
ABSTRACT
The paper introduced the trials and experiences acquired in carrying out the essential drug system in Dongtai city, Jiangsu province, probing into specific practices of improving such a system and deepening the medical and healthcare reform. Practices prove as advocated by the author that the building and betterment of an essential drug system characterized of "Zero price margin" in unified bidding, procurement and distribution. Such a system can not only alleviate the financial burden of diseases of the people, but also enhance clinical drug use safety, encourage rational use of healthcare resources, and promote patient satisfaction in the end.
ABSTRACT
OBJECTIVE: To analyze the effects of Essential Drug Systems on primary medical institutions. METHODS: According to related regulations for primary medical institutions in Suggestions on the Implementation of National Essential Drug Systems, the problems on the implementation of Essential Drug System were analyzed and discussed. RESULTS: The concepts of essential drug were not promulgated widely. Present essential drug supply guarantee system had limitation and essential drug distribution was kept at low level. Essential drug quality guarantee system had not been established and compensation supporting measures weren’t carried out completely. Above problems affected the implementation of Essential drug system in primary medical institutions. CONCLUSIONS: Government should set up multi-channel compensation mechanism and comprehensive evaluation mechanism for drug bidding, and select distribution enterprise rationally. Government also should increase the proportion of medical cost reimbursement in primary medical institution and improve the propaganda of National Essential Drug System.
ABSTRACT
OBJECTIVE: To provide reference for the implementation of Essential Drug System. METHODS: According to the contents of Essential Drug System and Basic Medical Insurance System in the New Medical Reform, the relationship between Essential Drug System and Basic Medical Insurance was analyzed. RESULTS: Essential Drug System and Basic Medical Insurance System were important aspects of New Medical Reform in China, which complemented each other. Basic Medical Insurance System improved the implementation of Essential Drug System, while Essential Drug System promoted the realization of policy targets of Basic Medical Insurance System. CONCLUSION: Basic Medical Insurance System should play a promotion role in the implementation of Essential Drug System.
ABSTRACT
OBJECTIVE: To provide reference for medical system reform in China. METHODS: According to Primary Medical Institutions Part of National Essential Drugs List (2009 edition), relevant aspects and reality of medical system reform and in China, policy connotation of Essential Drug System were analyzed to investigate the difficulties of implementation of Essential Drug System. RESULTS & CONCLUSION: Several problems should be resolved to implement essential drug system effectively, such as benefit assignment and financial support. The implementation of national essential drug system requires various efforts to achieve the goal of Medical Reform.
ABSTRACT
OBJECTIVE:To provide suggestion for full implementation and improvement of the national essential drug system in our country. METHODS:To analyze the defects of the Implementation process of national essential drug system in our country, and make recommendations for improvement. RESULTS & CONCLUSON: The system has been put into effect for one year; There were some performances and obvious defects in the national essential drug system in our country. Obviously, the problems of bid inviting and circulation were serious. And because of the low level of primary medical institution, it obstructed the pursue of system, we must vigorously promote and improve it, and to meet the people's demand of drugs.
ABSTRACT
OBJECTIVE:To provide reference for the establishment of coordinative mechanism among different interest groups during the implementation of essential drug system. METHODS:Based on game theory,game behaviors of various interest groups were studied with public medical institution as study core. Behavior relationships among various interest groups were ensured to find out equilibrium point of interests. RESULTS & CONCLUSIONS:In the implementation process of National Essential Drug System,great importance should be attached to the study on game phenomena and behavior among various interest groups to make sure implementation of National Essential Drug System.
ABSTRACT
OBJECTIVE: To provide reference for the implementation of essential drug system. METHODS: Relevance system allocation theory of institutional economics was applied to analyze essential drug system in China. RESULTS & CONCLUSION: Only coupling among internal systems of essential drug system form, can the gap of system be eliminated to realize the target of essential drug system.
ABSTRACT
OBJECTIVE:To provide reference for promoting the development of medical and health care in China.METHO-DS:The development process of national essential drug system was reviewed and analyzed and the experience of WHO was drawn on to design the future of national essential drug system in China.RESULTS & CONCLUSION:WHO proposed the concept of national essential drugs and recommended medical institutions to establish drug and therapeutics committee and to prepare "Standard Treatment Guidelines" and "National Formulary" for management of rational use of national essential drug.While essential drug system and basic medical security system have been worked out in China,their impacts of them are not satisfactory because of weak enforcement. "National Essential Drugs List ? The Part for Primary Health Care and Health Institutions" (2009 version) and National Formulary Indicate.The Part of Chemicals and Bidogical Products were published,and they are symbols of the re-beginning of national essential drug system.
ABSTRACT
OBJECTIVE:To analyze and summery the characteristics and clinical guiding significance of National Formulary?The Part of Chemicals and Biological Products(2010 version).METHODS:Literatures at home and abroad were retrieved and literature review method was applied for analysis.RESULTS&CONCLUTION:National Formulary?The Part of Chemicals and Biological Products(2010 version) includes four parts,i.e.general part,special part,national appendix and index.It represents as authority,guideline and Chinese characteristics as well as cultural and distribution characteristics professionally.Comprehensive and typical National Formulary is also characterized with timeliness because it is revised regularly.It had been written scientifically and freely and serves as standard for clinical drug use to improve diagnostic and therapeutic level,safety and development of drug use.
ABSTRACT
OBJECTIVE:To explore the establishment of performance indicator system for evaluating national essential drug system in China.METHODS:Reference to the field of health policy performance evaluation research and practice at home and abroad.WHO indicators for evaluating national drug policies,and a qualitative study on the theory and approach of policy evaluation was conducted.RESULTS & CONCLUSION:To establish a China-specific performance evaluation indicator system,policy goals should be specified,and evaluation criterions and policy components should be also defined firstly.An indicator system framework of national essential drug system which based on WHO recommendatory indicators should be proposed accordingly.But detailed indicators should be established based on field research and experts counseling.
ABSTRACT
OBJECTIVE:To provide reference for implementation of national essential drug system in various medical institutions.METHODS:The effect of national essential drug system on medical institutions was analyzed.RESULTS:The implementation of national essential drug system has various impacts on medical institutions in different levels,especially on primary medical institution,non-public medical institiution and military medical institution.CONCLUSION:Medical institutions were suggested to analysis the effect and put forward related countermeasures to cater to the changes and challenges of medical market and improve simultaneous development of social effect and economic effect.
ABSTRACT
OBJECTIVE:To propose the idea that the national essential drug system was improved with legislation method,for example revising Law for Medicine Management. METHODS:The requirement and feasibility of the legislation of national essential drugs were analyzed. RESULTS&CONCLUSIONS:The improvement of the national essential drugs system by legislation means is the demands of guaranteeing public rights for drug use,the inner requirements of implementing national health policy and the basic reflection of legislating law for medicine management. The feasibility of essential drugs legislation was improved by absorbing foreign advance experience with current essential drug policy as base. The conception and management category of essential drugs system was defined clearly based on the amendment of Law for Medicine Management,which could be the legal footing of the formulation and implementation of the supporting policies for essential drugs system.
ABSTRACT
OBJECTIVE:To promote the implementation of essential medicine system by combining drug utilization research with national essential medicine system. METHODS:The importance of information monitoring in the implementation of essential medicine system was analyzed and the application of drug utilization research in the implementation of essential medicine system was also discussed. RESULTS & CONCLUSIONS:It is suggested that the indicators for example DDDs are used in the monitoring of clinical drug utilization,and conditions also should be created to carry out further research of drug utilization so as to promote the implementation of essential medicine system in China.