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OBJECTIVE To sort out the common presentation forms and components of the framework of domestic and foreign essential medicine lists （EMLs）， in order to provide reference for optimizing the framework of the Chinese EML. METHODS The latest edition of the EMLs of WHO， China， South Africa， India， Malaysia and other typical countries were compared， and the similarities and differences of the presentation form and constituent elements of the list framework were analyzed. RESULTS & CONCLUSIONS The common presentation forms of WHO and typical countries’ EMLs included version， classifications and symbols， of which management ideas， functions， and implementation difficulties varied； common framework elements included target population， hospital levels， drug use conditions， core and supplementary lists and procurement priority. Through comparison， it was found that the information covered by the Chinese EML was relatively thin， and the framework design had not yet fully played the ideal role in guiding clinical rational drug use and optimizing the allocation of health resources， and there was still some room for improvement. It is recommended that China clarify the characteristics and roles of different presentation forms of the EML， and reasonably set the EML framework based on national conditions and development needs； the multi-dimensional drug information should be supplemented， such as clinical use， economy， and policy attributes of drugs in the EML， to ensure the rational use of essential drugs； it is also necessary to add “the level of hospitals” in the framework of the EML， refine the management requirements for the allocation and use of essential medicine， and optimize the resource allocation of hospitals.
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Objectives To analyze the allocation of major health resources in each district of Shenzhen from 2015 to 2019, to evaluate the equity of allocation, and to provide a reference for further optimizing the allocation of health resources. Methods Based on the statistics and analysis of the distribution of major health resources in Shenzhen from 2015 to 2019, the Gini coefficient was used to evaluate the equity of health resources allocation in Shenzhen from two dimensions of population and geography, and to analyze the trend of change. Results From 2015 to 2019, the total amount of health resources in Shenzhen maintained a rapid average annual increase of about 7.21%. The number of beds, doctors and nurses per every thousand people reached 3.81, 2.86 and 3.29, respectively. The Gini coefficients of each indicator decreased year by year. The Gini coefficient of population distribution was less than 0.3, and the Gini coefficient of geographical distribution was close to 0.5, exceeding the warning line. Conclusion The total amount of health resources in Shenzhen is insufficient and the distribution is uneven. The government should increase investment in health resources while taking into account the regional balance to improve the fairness of allocation.
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Abstract The objective of this study was to demonstrate face validity with a novel resource allocation framework designed to maximize equity into dental booking systems. The study was carried out in 2014. Eleven experts in primary dental care practice in Southern Brazil participated, using a three-round consensus group technique. First, the experts reached consensus on the items to be included in a 5-level diagnostic scale. They identified 21 clinical conditions and categorized them according to the oral health intervention required. Then, they described workload and activity standards for dental staff to carry out health promotion, oral disease prevention, dental treatment, dental rehabilitation, and urgent dental care. Finally, they agreed upon a set of wait times for primary dental care, establishing maximum waits from 2 to 365 days, according to the diagnostic classification. The framework demonstrated potential ability to promote more equitable access to primary dental services, since equal diagnostic classifications share the same waiting times for the dental care they require.
Resumo O objetivo do estudo foi demonstrar validade de face com uma nova matriz destinada a maximizar a equidade nos sistemas de agendamento odontológico. O estudo foi realizado em 2014, no qual participaram 11 dentistas com experiência de trabalho na rede básica de saúde da região sul do Brasil, utilizando a técnica de grupo de consenso em três rodadas de discussão. Primeiro, os participantes chegaram ao consenso quanto aos itens que deveriam estar presentes em uma escala de classificação diagnóstica de 5 níveis. Identificaram 21 condições clínicas de saúde bucal e as categorizaram conforme a intervenção necessária. A seguir, os participantes descreveram as cargas de trabalho e os padrões de atividade recomendados para a equipe odontológica realizar promoção da saúde, prevenção de doenças bucais, tratamento odontológico, reabilitação dentária, e atendimento odontológico de urgência. Por último, os dentistas chegaram ao consenso sobre tempos máximos de espera para atendimento odontológico na rede básica, estabelecendo prazos de 2 até 365 dias conforme a classificação diagnóstica atribuída. Este estudo demonstrou o potencial da matriz de alocação de recursos para promover acesso mais equitativo aos serviços odontológicos da rede básica, uma vez que classificações diagnósticas iguais compartilham os mesmos prazos de espera para o atendimento odontológico requerido.
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Humans , Primary Health Care , Oral Health , Dental Care , Brazil , Health PromotionABSTRACT
Objective:To discuss on the allocation and service utilization of health resources in maternal and child health care institutions and the existing problems in Guizhou Province,to provide a scientific basis for the further development of maternal and child health care.Methods:It analyzed the situation of health resource allocation,service utilization efficiency and maternal and child mortality in Guizhou province by means of statistical description,comparative analysis and correlation analysis.Results:The average number of health workers per hospital increased rapidly,the average number of beds per hospital grew slowly.The number of outpatient visits,the number of admissions and the number of people discharged were positive growth.The number of bed turnover,the working day of the bed,the bed use rate and the average hospitalization date appeared a certain degree of negative growth.Infant mortality rates,child mortality rates and maternal mortality rates under the age of five were all higher than the national average.Conclusion:Health resources of maternal and child health institutions in Guizhou should be tilted to the grassroots health institutions.It needed to further improve the efficiency of maternal and child health care use,strengthen the training of personnel and enhance the comprehensive service capacity of grassroots organizations.
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Objective To evaluate the quantity,category and the distribution of health resources of Traditional Chinese Medicine(TCM)in order to advise on optimizing TCM service system.Methods Based on the concept of agglomeration degree,this paper compared and analyzed the agglomeration of TCM resources in terms of medical institutions,their beds and medical workers.Results Currently the agglomeration degree of TCM health resources is found to be low,as TCM medical institutions tend to be small,with most of them being TCM clinics.Conclusions To rationalize the distribution of TCM medical resources,we must increase financial input and provide supportive policies,actively encourage healthy development of TCM medical institutions,strength TCM medical service system development in areas of poor TCM resources.
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To explore the allocation and equity of health resource in Changsha between 2007 and 2013 and to provide references for government to carry out regional health planning. Method:General statistical analysis was used to describe changes of health resource allocation in Changsha;from the perspective of the population and geography of the nine counties in Changsha, the equality and change of the configuration among doctors, nurses and hospital beds were analyzed by using the Gini coefficient and Theil index. Results:1) The per capita amount of health resources in Changsha increased gradually, and health resources were mainly concentrated in urban areas. 2 ) The Gini coeffi-cients of doctors, nurses and hospital beds was 0. 24~0. 46 according to population distribution between 2007 and 2013 in Changsha, and the Gini coefficient of all health resources by geography was 0. 59~ 0. 79 and peaked in 2009 to then decrease year after year. Following a comparison of the two kinds of regions, the Gini coefficient of urban are-as was significantly higher than that of rural areas, and the Gini coefficient of nurses was the highest among all health resources. 3) Changes in the Theil index were consistent with the Gini coefficient. The difference in the degree of re-source allocation in urban areas exhibited a rising trend, The Theil index was higher than each regional difference. Conclusion:Overall, the equity of allocation of health resources in Changsha between 2007 and 2013 gradually im-proved year by year. The equity of population configuration was greater than that of geographical configuration, and the equity of rural areas was superior to that of urban areas;the equity of the configuration of nurses was poor. The difference between areas is the main factor affecting the equity of Changsha’s health resource allocation.
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This paper introduced the fair benchmarks of evaluation framework for health system constructed by Daniels, et al, and its developmental application in evaluation of health resource allocation fairness .After introdu-cing the resources rational allocation of public health fair benchmarking fixed framework , this paper assessed the al-location of health resources according to the fixed framework .China has achieved good results in public health serv-ice interventions .But public sector governance , macro economic and social policy environment , factors such as ac-countability may restrict the improvement of the health care system .China's health expenditure allocations have un-fairness between provinces , urban and rural areas and different classes .China can use the new benchmark in the field of public health to promote the reform of health resource allocation fairness , make effective social health strate-gies.
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In this paper, we describe mismatch, chaos, and disorder behavior during healthcare seeking. Such structural imbalances, scarcity and surplus make healthcare services less efficient. We give reasons for such phenomena in terms of long-term effects of health resource allocation policy-making and implementation, inherent de-fects within healthcare insurance, incomplete market development, and cultural issues. We then propose four policy strategies, including rational price mechanism, strict referral healthcare system, confidence in basic healthcare facili-ties, and proper healthcare cultures. These will restore orderly healthcare behavior and help realize expectations for the current healthcare reform in China.
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Objective: To analyze the regional differences of the health resource allocation in Guangdong Province from 2002 to 2011, and provide the scientific basis for regional health planning and health resource allocation optimizing. Methods: The Theil Index was used to analyze the regional differences of the health resource allocation in Guangdong Province. Results: The health resource per capital is consistent with the national level, while differences existed in different areas, and the gap of the differences has been broaden during this period. Conclusions: The differences are caused by the difference distribution of material resources, human resources, the faulty of system and mechanism. Therefore, the hygienic resources disposition should be balanced establish reasonable mechanism to improve the equity of health human resources, strengthen the community health service as a breakthrough during the health system reform, and promote the equal access to basic medical and health services to narrow the gap of the regional differences and promote the equity of health resource allocation.
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Objective:Through comparing per capita allocation level of health resources in 31 provinces of China, the characteristics and the influencing factors of health resource allocation in each province are reveled. Methods: Selecting 7 representative indexes and using cluster analysis methods to divide per capita allocation level of 31 provinces into 5 grades; the influencing factors of per capita allocation level are proposed based on 5 grades and the ordered Probit model is built and estimated. Results: Beijing, Shanghai and Tibet respectively marked the first, the fourth and the fifth grade, 7 provinces ( including Tianjin) belong to the second grade, 21 provinces ( including Hebei ) belong to the third grade; four factors such as per capita GDP , family disposable income and so on all significantly affect per capita allocation level. Conclusion: Economic development and per capita allocation level of health resources are not balanced. The proportion of government health expenditure is negatively correlated with per capita allocation level of health resources.
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Through analysis of the general health status and resource allocation and utilization of health services needs of the state,the relationship between the two is discriminated,which suggests that we should strike a balance between the allocation of health resources and the health needs of the residents,to achieve the optimal allocation and utilization,to better serve the cause of development and the promotion of the health of the entire society,and improve health services and economic efficiency.