ABSTRACT
The current status of primary health institutions and personnels in China were analyzed based on the data from China Health and Family Planning Statistics Yearbook 2016 and China Health Statistics Summary 2018. By the end of 2017, there were 253 000 general practitioners in China, accounting for 7.46% of all practicing physicians or assistant physicians in the country(339 000). In 2017, the number of general practice residents was 8 517, accounting for 11.92% of all residents(71 430), which was 1.70% lower than that in 2016 (8 664) . The registered nurses in primary health care institutions were not sufficient, even the proportion of nursing to medical staff did not reach 1 ∶ 1 in primary settings. The distribution of primary health care institutions was not balanced. In the township hospitals and village clinics the number of practicing physicians or assistant physicians was far from meeting the requirement of the service. In view of the current problems, the social resources would be applied to promote the development of primary health care institutions and to improve the primary medical services in multiple ways such as personnel training, hardware construction, network construction and financial support, etc.
ABSTRACT
The current status of primary health institutions and personnels in China were analyzed based on the data from China Health and Family Planning Statistics Yearbook 2016 and China Health Statistics Summary 2018. By the end of 2017, there were 253 000 general practitioners in China, accounting for 7.46% of all practicing physicians or assistant physicians in the country(339 000). In 2017, the number of general practice residents was 8 517, accounting for 11.92% of all residents(71 430), which was 1.70% lower than that in 2016(8 664). The registered nurses in primary health care institutions were not sufficient, even the proportion of nursing to medical staff did not reach 1∶1 in primary settings. The distribution of primary health care institutions was not balanced. In the township hospitals and village clinics the number of practicing physicians or assistant physicians was far from meeting the requirement of the service. In view of the current problems, the social resources would be applied to promote the development of primary health care institutions and to improve the primary medical services in multiple ways such as personnel training, hardware construction, network construction and financial support, etc.
ABSTRACT
OBJECTIVE:To provide reference for improving the efficiency of medicine supply in primary health care institutions. METHODS:By stratified random sampling,6 counties of Dabie Mountains in Anhui province were selected as sample areas. Medicine purchase data of 143 primary health care institutions in 2015 were collected from Anhui provincial centralized purchase platform. Those data were analyzed in respects of purchase and distribution of National Essential Medicine,medicines of Anhui Province Essential Medicine List and cheap medicines. By stratified random sampling,12 primary health care institutions were selected for on-site interview. The reasons for medicine distribution and insufficient distribution were investigated. RESULTS:The rate of medicine distribution in the sample areas was 82.27%,and the rate of essential medicine distribution was more than 80%. Ratio of purchase amount for national essential medicines and medicines of Anhui Province Essential Medicine List were all up to standard in different types of primary health care institutions. The rate of cheap medicine distribution was in low level(only 80%). The distribution rate had great difference in the primary health care institutions and different areas;the highest rate of medicine distribution reached 99.86%,and the lowest was only 46.18%. The results of on-site investigation showed that main reasons for insufficient distribution were the divided area distribution model had a certain influence on the market competitiveness of the distribution enterprises,and distribution enterprises strength had huge differences. CONCLUSIONS:The primary health care institutions have high awareness of National Essential Medicine System in Dabie Mountains of Anhui Province;purchase rate and overall distribution rate of essential medicine are also high. There are great differences in distribution efficiency among different areas and health care institutions,and some health care institutions cannot distribute medicine in time with full capacity. It is suggested to conduct"two-receipt system"of medicine distribution,perfect medicine distribution enterprise supervision system, establish medicine circulation information platform and lead cheap medicine supply guarantee by government,etc. Those measures can guarantee the accessibility and selectivity of the masses to essential medicines in grass-roots areas.
ABSTRACT
The difficulty and expense of seeing a doctor was attributed to the out-of-level diagnosis and treatment, and the out-of-level treatment was due to the weakening of the basic medical service capacity. Since the new medical reform,the state has invested a lot, which led to the weakening of the primary medical service capacity. Exploring the institutional root of the weakening of grass-roots medical service ability could help to find the realistic path to enhance the service capacity of grass-roots medical institutions. Enhancing the service capacity of primary medical institutions was the only way to implement graded medical treatment. The administration of medical institutions restricted the improvement of service capacity of primary medical institutions, and the root of administration was the existing medical and health system. Only by starting from the reform of the system and realizing the administration of primary medical institutions, the service capacity of primary medical institutions could be enhanced.
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OBJECTIVE:To improve the distribution rate of essential medicines,to meet the medication needs in primary health care institutions. METHODS:The in essential medicine distribution in primary health care institutions was analyzed,and combined with the current essential medicine policy regulations,problems existed in the bidding work program of distribution enterprises that made by health departments were summarized,and countermeasures were put forward. RESULTS & CONCLUSIONS:Resources in medicament circulation industry get further integration,the industrial structure is optimized and upgraded,and the distribution rate is comprehensively improved after the implementation of national essential medicine system in Qinghai province. But there are still some problems,including serious monopolies in wholesale and sales enterprises,insufficient supply of some biding drugs,low distribution rate,inadequate supervision of relevant authorities,unreasonable regional distribution of drug retail stores and low qual-ity of distribution companies. For above-mentioned problems,relevant government departments should strengthen supervision and propaganda of relevant laws,regulations and policies for medicine distribution,intensity to supervise medical institutions,intro-duce competition mechanism,establish advanced pharmaceutical distribution and increase capital investment in drug sales in remote areas to effectively improve distribution rate of essential medicines and meet the needs of primary medical institutions.
ABSTRACT
OBJECTIVE:To provide reference for the further improvement of national essential medicines system. METHODS:Taking theBull's-eyecity Chengdu as an example,based on the trading areas,the existing problems in implementing essential medicine system were analyzed by qualitative and quantitative research methods,and countermeasures were put forward. RESULTS:From the point of view of quantitative data,the first level trading areas of both proportions of medical personnel per thousand ur-ban population and numbers of primary medical and health institutions per 100 thousands population in Chengdu were the lowest. From 2010 to 2012,the outpatient and inpatients increased 1.09 million people and 0.16 million beds per day in Chengdu primary health care institutions,the largest increase in the first level trading areas,and increase and decrease in the second and third level trading areas;outpatient and inpatient drug costs fell respectively 4 yuan and 109 yuan,medicine proportion declined 6.7%,in-crease in the first level trading areas,and decreased to varying degrees in the second and third level trading areas. From the point of view of qualitative interviews,the service ability got enhancement,but still could not meet the services demand,especially the pressure in the first level trading areas near center district remains heavy;drug cost was under controlled,but the subsidies needs to be increased,the per capita drug costs in the first level trading areas remains high;the drug income and medicine proportion were inhibited,especially the significant fell in the second and third level area,but the decrease of income may restrict develop-ment. CONCLUSIONS:It is suggested that more targeted drugs are needed for meeting the services demand,more sophisticated policy are needed for improving the subsidies,and more comprehensive medical conditions are needed for ensuring institutions'de-velopment.
ABSTRACT
BACKGROUND/AIMS: Stomach cancer is prevalent in Korea. The purpose of this study was to evaluate the characteristics of superficial gastric cancers detected at SOK Sokpeynhan Internal Medical Network, the nationwide primary health care institutions. METHODS: We prospectively analysed the clinicopathologic and endoscopic characteristics of 218 superficial gastric cancer patients diagnosed using gastric endoscopy at SOK network from January 2011 through December 2011. RESULTS: The mean age was 58.5 years old and male to female ratio was 1.7 : 1. Asymptomatic patients were most common (45.0%). The macroscopic classification revealed that simple types (63.8%) were more common than complex types (36.2%). The most common type was IIc (28.4%) and other types were as follows; IIb (16.1%), IIb+IIc (13.3%), IIa (10.6%), III (9.2%), IIa+IIc (7.3%), IIc+IIa (6.0%), IIc+IIb (5.0%). The most commonly involved sites were the body (53.1%) and greater curvature (32.6%) of the stomach. The size of lesion was less than 1 cm (69.3%) and less than 5 mm (33.5%) in diameter. The most common pathologic type was tubular adenocarcinoma (75.7%). Helicobacter pylori infection rate was 50.2%. Fifty five percent of the cases were diagnosed via endoscopy of National Health Insurance Corporation screenings. CONCLUSIONS: Superficial gastric cancers in 2011 at primary health care SOK network were different from those of previous reports. Type IIc was most common but type IIb was more prevalent and the body and greater curvature of the stomach were the most commonly involved sites. Therefore, careful observation of the proximal gastric mucosa and mucosal color change is needed.