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OBJECTIVE To provide ideas and inspiration for promoting the development of the generic drug industry and legal system of China. METHODS With text analysis， empirical research and other methods， the competitive generic drug incentive system in the United States was combed， its implementation effect and successful experience were analyzed， and the reference was provided for the implementation of relevant systems in China. RESULTS The competitive generic drug incentive system in the United States had achieved a satisfactory effect in three aspects： encouraging generic drug applications， accelerating the listing of generic drugs， and promoting drug price reduction， which was ultimately conducive to improving drug accessibility by publishing List of Off-Patent，Off-Exclusivity Drugs without an Approved Generic， while accelerating the development and review of generic drugs with insufficient competition and giving market exclusivity periods. CONCLUSIONS China’s reference to the competitive generic drug incentive system in the United States meets the needs of the current situation of domestic drug supply and also has the basis for industry practice. Therefore， we can refer to it， improve the system of releasing the catalog of encouraged generic drugs to be imitated， optimize the approval process for them， and authorize the exclusive period incentive to them.
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Objective:To evaluate the implementation effect of the "Shanghai Construction Project Centralized Air Conditioning and Ventilation System Hygiene Evaluation Specification （Trial）" （hereinafter referred to as the "standard"）. Methods:The "Centralized Air Conditioning and Ventilation System Hygiene Evaluation Report Score Sheet" was used to compare the quality of air conditioning hygienic evaluation reports before and after the implementation of the standard. Results:After the implementation of the standard， the total score of the air conditioning health evaluation report was significantly higher than that before the implementation （t=3.164， P=0.002）. The scores of format， general theory， engineering analysis and suggested conclusion after the implementation were all higher than before the implementation （t=3.701， 2.012， 2.152， 2.450， respectively， all P<0.05）. The difference in scores of evaluation process was not statistically significant between before and after the standard implementation （P=0.465）. Conclusion:After the implementation of the standard， the quality of air-conditioning health evaluation reports has significantly improved.
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OBJECTIVE：To evaluate the implementation of national drug centralized volume-based procurement （called “VBP”for short）in a public hospital，so as to provide reference for promoting VBP policy guided by value-based healthcare. METHODS：A total of 6 varieties and 12 specifications of antibiotics included in VBP in a public hospital in Chongqing were analyzed. The drug use data of the hospital one year before the implementation of VBP（i.e. April 20，2019- April 19，2020）and one year after the implementation（i.e. April 20，2020-April 19，2021）were collected and analyzed in respects of price change， generic drug substitution rate，average daily cost（DDDc），actual cost savings and other indicators. The problems and suggestions were put forward，and the effects of VBP policy implementation whether reflects the core connotation of value-based healthcare were evaluated. RESULTS：After the implementation of VBP，drug prices fell by an average of 63.44％，the average price drop of original drugs was 27.38％ ，and substitution rate of generic drugs was 25.59％ . DDDc of selected antibiotics in the hospital decreased in varying degrees，of which the decline of four drugs was 10％-40％，and that of Moxifloxacin hydrochloride tablets was 80.14％. Compared with bef VBP，6 kinds of antibiotics saved about 521 300 yuan，of which the imported Moxifloxacin hydrochloride tablets and Moxifloxacin hydrochloride sodium chloride injection saved 495 300 yuan（accounting for 94.97％ of the total cost savings of antibiotics）. CONCLUSIONS：The value of VBP based on the perspective of value-based healthcare is mainly reflected in the dual channel management mechanism of drugs，which improves the availability of drugs，effectively controls the unreasonable growth of medical expenses，reduces the expenditure of medical insurance fund，and helps to further reduce the drug burden of patients. At present，the implementation of VBP still faces difficulties，including the need for drug prices to return to a reasonable range，the need for foreign enterprises to change strategies to seek a breakthrough，and different therapeutic efficacy due to the difference in quality between the selected generic drugs and the original drugs. Therefore，the author believes that the pharmaceutical market structure should be transformed positively，value-based healthcare should help the regulation of medical insurance，and the consistency evaluation system should be optimized，so as to further improve the health level of patients.
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Objective To study the implementation effects of China′s contracted service policy for family physicians. Methods Systematic evaluation method was used to extract, describe and analyze the literature information of the research on the implementation effect of family physicians contracted service policy. Results A total of 80 papers of four types were rounded up, including 47 on the effect of health management on patients with chronic diseases, 11 on the effect of health management on the elderly, 15 on the effect on the first diagnosis in the community, and 7 on the effect on the control of medical expenses.The research is mostly distributed in the developed areas in the east. The family physicians contracted service promotes the health management effect of patients with chronic diseases and the elderlies, improves the first visit ratio of residents at their community, and effectively controls the medical expenses.Existing research shows that such a service has achieved initial success.However, the research also identified such common problems as the shortage and low competence of family physicians, low quality, resource integration and inadequate policy publicity. Conclusions The contracted service policy in China has begun to play the role of " health gatekeeper" and " cost gatekeeper" to some extent.It is suggested to strengthen the training of general practitioners, establish and perfect incentive mechanism, and improve the construction of information platform, while the implementation effect of contracted services for family physicians deserve further study in a broader scope, deeper level and design specifications.
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The purpose of this article is to evaluate the clinical effect of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for acute tonsillitis. The applicability and application of the Guideline were evaluated based on the clinicians by using the electronic questionnaire. Questionnaires about 538 on application evaluation and 502 questionnaires on applicability evaluation were completed from April 28 to July 9, 2018. The subjects in the questionnaires include the clinicians with junior title, intermediate title, and senior title that have used this Guideline. The descriptive statistical analysis of the collected questionnaire was carried out. In the applicability evaluation, according to the classification of professional titles, the application rate was highest in intermediate title clinicians (26.77%), followed by junior (23.98%) and deputy senior (19.33%) professional title clinicians. In the quality evaluation, the rationality of application scope (98.61%) and the terminology accuracy (98.81%) scores were higher, and the rationality of differentiation and classification (96.05%) was the lowest. The applicability evaluation suggested that clinicians believed this Guideline had high safety (98.42%), reasonable content (98.03%), significant effect (99.6%), reduced use of antibiotics in Western medicine (93.89%), and a high applicability ratio (96.44%). In the application evaluation, Department of lung disease showed the highest application rate (44.24%); rationality of the Guideline was more than 97% in treatment rules and prophylaxis except the syndrome differentiation (92.75%); a high ratio of clinicians believed the recommended scheme was good: curative effect 97.4%, safety 97.59%, and economy 93.87%. The study shows that the clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for acute tonsillitis is of good quality, high clinical use and good effect. It can be used as a standardized treatment scheme for acute tonsillitis in traditional Chinese medicine. But there are some unsuitable contents and need to be further improved. The Guideline should strengthen the revision on differentiation of symptoms and signs as well as prophylaxis.
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Humans , Anti-Bacterial Agents , Medicine, Chinese Traditional , Practice Guidelines as Topic , Surveys and Questionnaires , Syndrome , Tonsillitis , Drug TherapyABSTRACT
Objective · To compare the prevalence of tobacco advertisement before and after implementation of the new edition of Advertising Law of the People's Republic of China and evaluate the effects of implementation of the new Advertising Law. Methods · Tobacco sales places, public places, and streets in Shanghai were randomly selected to observe tobacco advertisement and complete the survey. The survey was carried out in 10 districts of Shanghai in June 2015 with 10 tobacco sales places selected in each district, and in 4 districts of Shanghai in June 2016 with 25 tobacco sales places selected in each district. Sales places included convenient stores, tobacco stores, supermarkets, and kiosks. In addition, public transport waiting points, public transport vehicles, hospitals, shopping centers, restaurants, bars, and Internet cafes were selected into survey in 2016. Results · In 2016, the proportion of tobacco sales places having tobacco advertisement was lower than that in 2015, but the proportion of tobacco promotion behaviors was higher. In 2016, 128 public places and streets were investigated and only 1 had outdoor tobacco advertisement. Conclusion · The new edition of Advertising Law has significant effect on controlling tobacco advertisement, but tobacco sales places still have tobacco advertisement with various disguised promotion forms. Tobacco sales places have diversified business styles and minors often enter these places. It is recommended that a clear definition of disguised forms of tobacco advertisement should be made, tobacco advertisement at tobacco sales places needs to be supervised, the release of tobacco advertisement should be strictly reviewed, and existing tobacco advertisement should be severely punished, so as to prevent minors from exposing to tobacco advertisement and information luring smoking.
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OBJECTIVE:To provide reference for evaluating the new round of essential medicine bidding and purchase policy in China,ensuring the stability of essential medicine supply and improving national essential medicine system.METHODS:Based on the theoretical analysis,taking Shanghai and Yunan province as sample,the questionnaire was designed to investigate the difficulty to implement essential drug purchase policy in essential medicine supply system,and the bidding situation evaluation of production enterprises by both sides of local drug bidding among staff in production enterprises,circulation enterprises,primary health care institutions and other institutions.The types of influential factors for the implementation of essential medicine purchase policy were determined finally.Factor analysis method was used to screen the key influential factors.RESULTS & CONCLUSIONS:Four common factors had a great influence on the implementation of essential medicine policy in China.The impact of the large to small is the rationality of the tender procurement program,the standardization of pharmaceutical production,the stability of demand for drug use and macroeconomic policy regulation and protection.It is suggested to further improve the drug recruitment system,select the products that have quality assurance and production specifications,and fully meet the diverse needs of the market,while provide relatively stable usage information for manufacturers.If necessary,"drug purchase with target quantity" of Shanghai model can be forced to carry out by policy so as to ensure that the interests of all parties in the pharmaceutical supply chain are treated fairly.
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OBJECTIVE:To provide reference for improving the work quality of Pharmacy intravenous admixture service(PIV-AS). METHODS:The quality control monitoring system for PIVAS established and implemented in our hospital was introduced, the monitoring system was tracked and checked from initial stage of implementation (Jan. 2016) to implemented for 12 months (Dec. 2016),and the effect was evaluated. RESULTS:PIVAS in our hospital had developed quality control monitoring system that included medication error and critical error monitoring system,auditing medical order homogenization monitoring system,hand hy-giene monitoring system,high-alarm drug management monitoring system and drug liquid residue monitoring system. In initial stage of implementation,the relevant checking indexes including incidence of medication error and critical error,standardization rate of auditing medical orders,awareness rate of hand hygiene knowledge,compliance rate of hand hygiene,correct rate of hand hygiene,pass rate of high-alarm drug management and pass rate of drug liquid residue were 0.14%,57%,85%,70%,86%, 98%,75%;and after implemented 12 months,the indexes were 0.01%,87%,97%,81%,95%,100%,93%,respectively (P<0.05). CONCLUSIONS:The quality control monitoring system in PIVAS established and implemented in our hospital has ef-fectively improved the work quality of PIVAS.
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Objective:To conduct a systematic review on the implementation effects of National Essential Medi-cine System ( NEMS) since the new health care reform and provide some suggestions to further improve the NEMS. Methods:Databases and relevant international organization reports were searched to collect studies related to the im-plementation of NEMS in China. The database search occurred from January 2009 to December 2014. Results:A to-tal of 1 292 studies were finally included, encompassing 1,277 Chinese papers, 12 English papers, and 3 WHO/HAI reports. A lot of researches have been done on NEMS, but the techniques of NEMS evaluation are not perfect. The sample representativeness is poor, and the longitudinal follow-up studies of the microscopic view is insufficient. . Evi-dence-based evaluation research using big data has just started. Conclusions: The research on NEMS should be strengthened. The NEMS evaluation should not only be based on national conditions, but it should also be in combi-nation with an international, multidimensional evaluation framework in terms of availability, affordability and rational drug use, so as to provide evidences to perfect the NEMS.
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Payment system reforms have become an important part of Chinese healthcare reforms, and global budget has been seen as a major trend. Based on the practice and data of four pilot hospitals in Beijing which have implemented the global budget, this paper focuses on analyzing the effects of implementation on the following aspects and provides references for policy improvements: medical services, average medical cost, total health expenditure, medical cost structure, average length of stay and out-of-pocket expense percentages.
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Objective To evaluate the implementation effect of Malaria Elimination Project supported by the Global Fund in Shaanxi Province so as to provide the evidence for the scientific implementation of Malaria Elimination Action Plan and the exami-nation and evaluation work. Methods The data of malaria prevention and control work were collected and analyzed statistically in 27 counties from 2010 to 2012 in order to evaluate the measures and effects of malaria control. Results There were 64 reported cases in the project areas from 2010 to 2012,and the average annual incidence rate was 0.15/10 million with a declining trend. The infected area sources of patients were mainly imported overseas accounting for 79.69%of the total cases. The blood completion rate of febrile patients was 94.14%,and the scope of the blood smears testing work had expanded to 88 counties(including 61 third-class counties). The training coverage rate of malaria prevention knowledge and skills had achieved to 100%. The awareness rates of malaria prevention and control were 91.68%and 89.44%in the students and local residentsrespectively. The case reporting with-in 24 h after diagnosed,epidemiological case study and outbreak disposal,laboratory testing and confirming and the other case management capabilities had also improved significantly. Conclusions The implementation of the Global Fund Malaria Project in Shaanxi Province has accelerated the process of Malaria Elimination work and improved significantly the malaria control ability in the project areas.
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OBJECTIVE: To provide a suggestion for legislation of rare disease in China.
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Objective To analyze the implementation effect of formative assessment in nutri-tion and food hygiene. Methods 55 students of Class One from grade 2010 majoring in preventive medicine were taken as the control group, with 56 students of Class Two as the experimental group.The control group used the summative assessment , while the experimental group used the formative assessment. Results were analyzed by course examinations and questionnaire surveys. SPSS 17.0 soft-ware was used and the measurement data were expressed by x±s. Statistical analysis was performed using t test, test, rank sum test, a Yuan linear correlation analysis, with the level of test α=0.05. Results The experimental scores and final scores of experimental group students were significantly higher than the control group and the difference was statistically significant(P values were 0.001, 0.000). The experimental group's overall result is closer to the negative skewed distribution. The ex-perimental group's average score of 89 points is significantly higher than the control group's average score of 79 points(P<0.01), and the usual results and the final results were positively correlated(r=0.865, P<0.001). The survey indicated that the students recognized the application of formative assess-ment in teaching process . Conclusion Formative assessment can help improve the teaching and learning quality in nutrition and food hygiene.
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ObjectiveTo understand the implementation effect and its influencing factors of clinical medical undergraduates' talents cultivation scheme in Xinjiang Medical University. Methods 421 clinical medical students completed questionnaire. The main contents of the survey are general situation, the factors and the implementation effect of the cultivation scheme, and so on. Results①The talents cultivation scheme is reasonable and feasible. ②The main factors which affect talents cultivation scheme of our school are the teaching plan arrangement and practical course arrangement. ③Talents cultivation scheme in the implementation process achieved some success, but the cultivation of humanistic quality should be enhanced, etc. ConclusionRenewed the education conception, optimize the clinical teaching structure, integrated teaching contents, updated teaching methods and means, and strengthened students' humanistic quality are the key factors of the higher medical institutions to cultivate high quality and comprehensive talents.