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【Objective:】 To explore the current situation and problems of village-level health human resource allocation based on the theory of policy change, and to help rural revitalization and healthy rural construction from the perspective of "consolidating the basic level foundation as fundamental policy". 【Methods:】 a) Information census method. A round-the-box survey on the distribution of health human resources at village-level in 14 rural towns and villages in H district was conducted. b) In-depth interview method. Based on the principle of information saturation, three township and villages clinics and community stations were selected for field observation, and in-depth personal interviews were conducted with key insiders. 【Results:】 The health policy environment changed significantly with the spatiotemporal changes. "Hollow village" and "inverted village" coexisted. The change of registered population and permanent resident population accelerated, old village doctors and new village doctors continued on the same hand, village clinics and community station were in "double track" of management progress. With the change of internal and external environment of the above-mentioned policies, the allocation of health human resources at village level needs to be studied urgently. 【Discussion:】 Under the dual function of external and internal environment, the policy change is inevitable. The health human resource distribution at village-level should be integrated with the system in terms of policy. The career development mechanism is connected up and down. Team construction revolves around suitable and applicable for batch training.
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OBJECTIVE：To identify and evaluate the risk factors of innovative drug clinical trials ，and to provide references for the development of risk management and control strategies. METHODS ：Using the method of literature research ，the risk factors of innovative drug clinical trials were obtained ，classified and sorted out ，and the risk evaluation indicators were initially formed. On this basis ，the questionnaire was designed. By means of interview and questionnaire survey ，54 experts were invited from 4 tertiary hospitals and 1 contract research organization to score. SPSS 24.0 software was used to perform principal component analysis on risk event status data. RESULTS & CONCLUSIONS ：The risk evaluation system included 9 first-class indicators such as policy and legal risk ，clinical trial institution risk and trial scheme design risk ，and 31 second-class indicators such as industrial policy，law and regulation changes ，intellectual property risk . According to the analysis ，the risk factors of innovative drug clinical trials mainly included drug and biological sample management risk ，trial scheme design risk ，clinical trial institution risk ，safety report management risk ，ethical review risk ，policy and legal risk ，and subject management risk. Relevant parties in clinical trials need to focus on monitoring various risk factors ，establish dynamic monitoring and control mechanism and implementation guarantee mechanism ，and effectively prevent and control risk ，to promote the smooth implementation of clinical trials.
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@#<p><strong>BACKGROUND AND OBJECTIVE:</strong> Research plays an important role in generating new knowledge that could improve health outcomes when translated into action. As such, there must exist a supportive research policy environment that facilitates the provision of necessary resources and sustainably ensures an appropriate number of skilled researchers buttressed by institutions. These, in turn, are envisioned to provide facilities, information systems, financial grants, and avenues for career development and collaboration. This study aims to analyze factors in the current policy environment that makes health research possible in the Philippines.</p><p><strong>METHODS:</strong> Qualitative exploratory design was used to characterize the Philippine health research environment. Guided by Adamchak's framework on policy environment, a content review of 39 policy documents (1991 to 2018) by the four core agencies of the Philippine National Health Research System was conducted. Seven elements of the policy environment were described.</p><p><strong>RESULTS:</strong> The policies analyzed in this study mainly addressed the legal, political, cultural, economic, and ecological elements of the policy environment. Policies that support the demographic and technological elements are lacking, in that these leave out details that are essential for capacity building and use of research output. A cross-cutting effort to resolve gaps may be necessary.</p><p><strong>CONCLUSION:</strong> Several factors continuously affect the environment in which policy is developed. There is room for improvement in terms of showcasing the government's regulatory quality and independence from political pressure. Equal attention must also be paid to human capital development, innovation partnerships, and mechanisms to improve knowledge impact, absorption, and utilization.</p>
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Capacity Building , PhilippinesABSTRACT
Objective To study the impact of policy external environmental changes on rural doctors'ranks,and to find out the adaptability between the two.Methods The purposeful sampling method was used to study 84 people of district H in Beijing by means of both field observation and individual in -depth interviews from July to August in 2016.The data acquired was analyzed by qualitative method, and interview results were categorized and analyzed by citing typical expressions of the respondents.In October 2016,rural doctors from 260 village clinics in 14 townships in district H were subject to a basic information survey,by means of general description.Results The changes of village governance model, strength of personal relationship made in adaptation between health policy and policy environment,retained the practice of senior village doctors.These people,though low in competence,were advantageous as being locals(237 of them being in the same village)and for their familiarity with health conditions, namely family disease history and diet habits,of local villagers.At the same time,health policies were not adaptive to the policy environment,as village committees tend to ignore management of doctors.12 of the 21 village leaders were not involved in the management.Conclusions Development of rural doctors ranks is highly challenging as making policies friendly to external policy environment, and the constraints of such environment on health policies deserves more attention.
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Objective To survey the current status of the rural primary medical service supply in Beijing suburb,and to discuss the relationship between policy environment and rural primary medical service.Methods A purposeful sampling method was adopted to select Beijing Huairou District as the study site.In July to August 2016 a questionnaire survey was conducted among 260 village doctors from 260 village clinics in 14 townships;21 village clinics were site visited;21 village leaders,21 village doctors,and 42 villagers were invited for in-depth interview.The impact of policy environment on the provision of =basic health service at the village level was analyzed.Results The facilities of the 260 village clinics basically met the needs,but the service quality was still insufficient.The basic situation of village clinics:174 villages (66.9％) were funded by the "1 486" project,164 (63.1％) village clinics were located in the center of the village.In 173 village clinics (66.5％) the legal representatives were village leaders,but 11 (52.4％) village officials thought that rural doctors should be the legal persons.The mean age of 260 village doctors were (62.7 ± 8.9) years.Among 260 village doctors,168 (64.6％) were working more than 40 years,149 (57.3％) had secondary medical education,72 (27.7％) had no medical professional qualification;247 (95％) held practice certificates of rural doctors and only 3 (1.2％) held medical license;244 (93.8％) village doctors took subsidy from the government.The continuing education was organized monthly by the township health centers.The source of training teachers was township health centers (247,95.0％).The teaching form was mainly audio-visual education (191,73.5％);the content was based on general medicine (245,94.2％).The top 5 basic medical service items provided by village clinics were the diagnosis and differential diagnosis of common diseases,family visits,measurement of blood pressure,respiratory and pulse rates,body weight,height and vision,and intramuscular injection.Most village doctors (199,76.5％) provided night-time medical service.For the medical care needs,22 (52.4％) villagers said they were basically satisfied.The most satisfying aspect was the service attitude,and the most unsatisfactory aspect was the equipment and facilities.The management function of village committee was mainly in personnel recruitment (231,89.5％),daily supervision (218,84.5％) and performance assessment (113,43.8％).The assessment of service quality was conducted by the township health service centers,particularly in public health service.Conclusions The current status of rural primary medical service still cannot fully meet the needs of rural residents.In order to upgrade the quality of rural primary medical service to meet the health needs of villagers,it is necessary to improve the internal policy environment,such as villager autonomy,socio-economic development and so on.
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In this paper, 172 non-public hospitals have been investigated covering east, central and western regions with structured and semi-structured questionnaire and group interviews. We found that the health insurance policies were the most concerned policies by non-public hospitals, accounting for 26.5% of the total. We also found that non-public hospitals from different areas, levels profit nature have different policy expectations, for example Eastern regional institutions wanted to make a breakthrough of the planning policies, the central region wanted to change the health personnel policy, while the western region is considered to be limited by land policy. Tertiary hospitals were more concerned about research projects and land policy, and secondary hospitals were more concerned about access policy. There were 44.8% of the surveyed institutions considered that regulatory policywasmore stringent public hospitals and public hospitals, and there were no difference between profit and non-profit hospitals. According to the survey results, this paper puts forward suggestion that we should implement more targeted policies, purchasing more services from non-public hospitals and enhanced supervision. Considering the survey results research team puts forward sensitive advice as: provide preferential policies in according with different kinds of institutions reinforce purchasing service and enhance non-public hospitals supervision.
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After the position and difficulties of traditional scientific literature novelty assessment were described, the changing policy environment of scientific literature novelty assessment and its effect on its developmen were ana-lyzed, with suggestions put forward for the reform of scientific literature novelty assessment, including seeking poli-cy support and taking advantage of the opportunity, deep mining and optimizing explanation, dividing team and in-tegrating resources, taking measures in light of the situation and transforming service.
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Objective To find out about the current state of development and existing problems in non governmental hospitals and to explore their development direction by collecting quantitative and qualitative data. Methods Investigations in the form of questionnaires were made into all the non governmental hospitals province wide and a descriptive analysis was made of the data collected. Results Non governmental hospitals in the province witnessed fast development, and yet they were generally small scaled, lacked actual strength, and were unevenly distributed, claiming only 3% of the market share; they paid special attention to the unique features of specialties and employed flexible operational modes, and yet they were still confronted with such problems as insufficient support policies from the government and personnel instability. Conclusion There is still a long way to go before the monopoly of state run hospitals is broken, diversified modes of hospital running are developed, and fair and orderly competition is formed so as to enhance the vitality of medical institutions. Administrative departments of health should fully realize the role and social functions of non governmental hospitals and actively lead their development in a healthy direction with sound policies.