Analysis of Chinese elderly health policies based on policy tools / 预防医学

Objective@#To analyze Chinese elderly health policy documents from 2018 to 2022 based on policy tools, so as to provide insights into improving elderly health policies and promoting healthy aging. @*Methods@#Elderly health policy documents were retrieved from “the magic weapon of Peking University”, the policy document database of the State Council and portal websites of relevant ministries and commissions using keywords “elderly”, “aging” and “elderly health”. The documents were encoded using content analysis and keywords were extracted. A two-dimensional analysis framework was constructed based on Rothwell and Zegveld's classification framework and dimension theory, and the use of policy tools was analyzed. @*Results@#Totally 57 Chinese elderly health policy documents were collected from 2018 to 2022, including 44 notices, 7 opinions, one rule, one regulation, one law, one announcement, one letter and one joint declaration. There were 37 documents (64.91%) issued by National Health Commission and its departments and offices. The high-frequency keywords in the documents included “medical and healthcare institutions”, “elderly health”, “rehabilitation/nursing”, “community/grassroots/rural”, “pilot”, “traditional Chinese medicine”, “propaganda” and “standardization”. There were 413 document codes, and the supply-, environment- and demand-side policy tools accounted for 52.54%, 31.72% and 15.74%, respectively. Public health and medical services (19.61%) and science popularization (7.99%) were the most commonly used supply-side policy tools, law/regulations and administration systems (7.99%) was the most commonly used environment-side policy tools, while pilot/demonstration projects (5.33%) was the most commonly used demand-side policy tools. The external and internal indicators of the system dimensions accounted for 48.18% and 51.82%, and political system (17.19%) and technical system (16.46%) were the two most commonly used external indicators, while service system (35.60%) was the most commonly used internal indicator.@*Conclusions@#Chinese elderly health policies focused on supply-side policies from 2018 to 2022, such as public health and medical services. The use of demand-side policy tools is recommended to be increased and the internal composition of supply- and environment-side policy tools are recommended to be optimized.

Analysis and optimization of policy tools for TCM formula granules in China / 中国药房

OBJECTIVE In order to analyze the current situation of policy tool allocation in China’s TCM formula granule industry， and provide a theoretical basis for the high-quality development of the industry. METHODS Based on the perspective of policy tools，“ TCM formula granules” was used as the keyword to retrieve the official websites of departments directly under the State Council such as the National Medical Products Administration and the National Administration of Traditional Chinese Medicine， as well as provincial governments. The relevant clauses in the policy documents related to TCM formula granules in China from 1993 to 2022 were encoded， and then the application of policy tools was summarized and classified. RESULTS & CONCLUSIONS A total of 12 national documents and 77 provincial documents were ultimately selected， involving 556 relevant policy clauses. It was found that among the relevant policy tools， environmental policy tools had the highest degree of attention， accounting for 62.6%； the proportions of demand-oriented policy tools and supply-oriented policy tools were less， accounting for 17.8% and 19.6%， respectively. From the perspective of policy tools， the use of demand-oriented policy tools in current policy texts was relatively simple， and various policy tools were given low attention； from the perspective of policy objectives， the proportion of use of environmental， demand-oriented and supply-oriented policy tools were not balanced enough. It is suggested to increase the proportion of demand- oriented policy tools to meet international competition； emphasize the use of supply-oriented policy tools to strictly control product quality； consolidate the use of environmental policy tools to standardize quality standards. On this basis， we will coordinate the overall situation， balance the use of various policy tools and promote the development of TCM formula granule industry.

CHINA PH ARMACY Volume 33，Number 14，July 30，2022 Semimonthly Table of Contents Analysis of pediatric drug policies in China on the basis of policy tools / 中国药房

OBJECTIVE To provide refere nce for the optimization and adjustment of the relevant policies in the field of pediatric drug in China. METHODS“Children”“pediatrics”and“drugs”were taken as the keywords to search the official websites of the State Council ，the National Health Commission ，the National Healthcare Security Administration ，the State Administration of Market Regulation and other relevant ministries and commissions ，and collect the relevant pediatric drug policies issued at the national level from January 1，2010 to December 31，2021. Content analysis method was used to summarize ，code and statistically analyze the policy tools used in the policy research documents. RESULTS A total of 39 policy documents and 327 policy tools were included in this study. According to statistics ，from 2011 to 2021，China issued national policy documents on pediatric drug use every year ，and in recent years ，the issuance of documents was relatively intensive. The main body of issuing pediatric drugs policy was the national health department and drug supervision and administration department （71.79％，28/39），and the number of documents issued by relevant ministries and commissions alone （76.92％，30/39）was significantly more than the number of documents jointly issued by multiple ministries and commissions （23.08％，9/39）. The environmental policy tools were the most widely used （64.83％，212/327），followed by s upply-oriented policy tools （30.28％，99/327），and demand-oriented policy tools were the least used （4.89％，16/327）. CONCLUSIONS The development of pediatric drug use in China is in its infancy. It is suggested that China should optimize supply-oriented policy tools，increase capital investment and the use of public health service tools ；adjust environmental policy tools ，accelerate the legislation of pediatric drugs ，and increase the proportion of incentive policy tool ；attach importance to demand-oriented policy tools ，strengthen international exchanges and the application of service outsourcing in the field of pediatric medication ；plan the use of various policy tools as a whole ，and coordinate the use proportion of three types of policy tool and their sub policy tools，so as to enhance the initiative of policy tools ，form policy synergy ，and jointly promote the development of pediatric drug use.

Policy analysis on the long-term care for disabled elderlies from the perspective of policy tools / 中华医院管理杂志

Objective:To analyze the focuses and shortcomings of the long-term care policy for disabled elderlies in China, for references to optimize such policies.Methods:The data came from the policy documents on long-term care for disabled elderlies published on respective official websites of various ministries and commissions from January 1, 2013 to April 20, 2022. Text quantitative analysis was used to extract policy clauses, and three types of policy tools(including 13 types of sub-tools) were used to analyze these provisions.Results:132 clauses were extracted from a total of 34 policy documents, of which the number of clauses of supply, demand and environmental policy tools were 28(21.21%), 25(18.94%) and 79(59.85%) respectively. There were few clauses on scientific and technological information support(5) and capital investment(3) in the supply-type policy tools; In terms of demand-based policy tools, there were only a few clauses for government purchase(5), pilot projects(3) and service outsourcing(2); In terms of environmental policy tools, there were only a few clauses for standard design(9) and supervision and management(7).Conclusions:The long-term care policy structure of the disabled elderly in China was not balanced, the supply-based policy tools had less scientific and technological information support, the demand-based policy tools were short and single, and the environment-based policy tools were widely used but lack of standard design. Relevant policy-making departments should further improve the accuracy of policy targets, optimize the internal structure of policy tools, pay attention to the application of scientific and technological information policies and clarify the relevant standards of care services.

Instrumentos e integração de políticas públicas: a rede do Cadastro Único / Instrumentos e integración de políticas públicas: la red del Registro Único / Instruments and public policy integration: the network of the Single Registry for Social Programs

Resumo Este artigo analisa a capacidade de integração de políticas públicas suportadas por um mesmo instrumento de implementação. Partindo da abordagem dos estudos de implementação de políticas públicas que compreendem os instrumentos como "o estado em ação", isto é, ferramentas de ação pública por meio das quais a ação governamental se materializa e é operacionalizada (Lascoumes & Le Galès, 2007; Linder & Peters, 1990), examina-se o caso da Rede do Cadastro Único para Programas Sociais, formada pelo instrumento do Cadastro Único - composto por sua base de dados, normas, processos e estrutura municipal de cadastramento e coleta de dados - e pelos 20 programas sociais que se utilizam de suas informações cadastrais sobre 27 milhões de famílias, quase 80 milhões de pessoas de baixa renda, para seleção de beneficiários e gerenciamento de políticas voltadas ao combate das diferentes formas de vulnerabilidade social. Adotou-se a metodologia da análise de redes sociais para responder a duas perguntas principais: qual é a posição ocupada pelo Cadastro Único (CadÚnico) na rede de relações formada com as políticas sociais que o utilizam e quais são as condições e o nível de integração que o CadÚnico promove entre essas políticas usuárias? As métricas e os sociogramas de dois contextos temporais distintos, 2016 e 2018, demonstraram que, embora haja potencial para que promova maior integração entre as políticas, o CadÚnico ainda não se apresenta como instrumento potente de integração de políticas públicas.

Resumen Este artículo analiza la capacidad de integración de políticas públicas sustentadas por un mismo instrumento de implementación. Partiendo del enfoque de los estudios de implementación de políticas públicas que comprenden instrumentos como "el estado en acción", es decir, herramientas de acción pública por medio de las cuales la acción gubernamental se materializa y se pone en marcha (Lascoumes & Le Galès, 2007; Linder & Peters, 1990), se examina el caso de la Red del Registro Único para Programas Sociales, formada por su base de datos, normas, procesos y estructura municipal de registro y recolección de datos y también por los 20 programas sociales que utilizan la información de registro de 27 millones de familias, casi 80 millones de personas de bajos ingresos, para selección de beneficiarios y gestión de políticas dirigidas al combate de las diferentes formas de vulnerabilidad social. Se adoptó la metodología de Análisis de Redes Sociales para responder a dos preguntas principales: 1) ¿Cuál es la posición que ocupa el Registro Único en la red de relaciones formada con las políticas sociales que lo utilizan? 2) ¿Cuáles son las posibilidades y el nivel de integración que el Registro Único promueve entre esas políticas? Las métricas y sociogramas de dos contextos temporales distintos ‒2016 y 2018‒ demostraron que, aunque haya potencial para que promueva una mayor integración entre las políticas, el Registro Único todavía no se presenta como instrumento potente de integración de políticas públicas.

Abstract This article analyzes the capacity of policy integration through implementation tools. The research builds on studies on policy implementation, which understand such tools as "the state in action," i.e., instruments through which governments operate and deliver public services (Lascoumes & Le Galès, 2007; Linder & Peters, 1990). The research examines the case of the Brazilian Single Registry for Social Programs (Cadastro Único or CadUnico). The Single Registry is understood as part of a network providing social protection to the Brazilian population in social vulnerability. This work examines CadUnico as a complex system formed of a database and a set of norms and processes that work within the structure of local governments. The system gathers data used to coordinate 20 social programs, helping to select beneficiaries and manage policies that serve 27 million low-income families, reaching almost 80 million people. We adopted the social network analysis as a research method, seeking to answer two main questions: what is the position occupied by the Single Registry in the network of relationships formed by the federal social policies which use it, and what are the conditions and the level of integration which it promotes among these federal user policies? The metrics and sociograms of two distinct timeframes, 2016 and 2018, have demonstrated that, although the Single Register for Social Programs offers elements to promote some integration among public policies, there is no evidence of its effectiveness to this end.

Textual Quantitative Analysis of Essential Medicine Policy Texts in China from the Perspective of Policy Instru- ments / 中国药房

OBJECTIVE：To summarize key factors and shortcomings of essential medicine policy in China from 2009-2019， and to provide reference for the formulation and improvement of follow-up policy. METHODS ：Through the official websites such as National Health Commission and Chinese government website ，as well as other policy searching websites ，using“essential medicine”as key words，related policy texts were collected. Rothwell classification method was used to construct the analysis framework of essential medicine policy. The contents of policy texts were classified and coded by Excel 2013 software，and the codes were classified into the essential medicine related policy analysis framework. The descriptive analysis was carried out by SPSS 22.0 software，and the essential medicine policy was analyzed according to data distribution characteristics ，and the results were explained. Corresponding suggestions were put forward. RESULTS ：A total of 15 essential medicine policy texts were screened and obtained. X-dimension of the analysis framework of essential medicine policy included 3 types of basic policy tools ， Incorporat - counting for environmental effects and statistical noise in ing the operating environment into a nonparametric mea - data game formulations and interpretations for data envelopsupply-oriented ，environment-oriented and demand-oriented tools ；Y-dimension was the essential medicine policy objectives of accessibility，quality and rational use. From X-dimension ，the frequencies of above 3 basic policy tools use were 20.12％ ， 66.46％，13.41％，and the environmental policy tools were the most frequently used ；from Y-dimension ，the frequencies of above 3 objectives were 43.90％，32.93％，23.17％，the frequency of accessibility was the highest. The test results showed that there was statistical significance in the use frequency of X-dimension in Y-dimension （χ2＝11.719，P＝0.025＜0.05）. CONCLUSIONS ：The use frequency ratio of different essential medicine policy tools is different ，so it is necessary to reduce the frequency ratio of environmental policy tools ；there are differences in the internal structure of policy tools ，so it is necessary to optimize the structural allocation among policy tools ，and pay attention to the construction of demand-oriented tools . It is suggested that the accessibility of essential medicine should be enhanced ，and the connection between essential medicine list and medical insurance list should be strengthened；great importance should be attached to drug quality and drug quality supervision ；the scope of rational use of essential medicine should be clarified ，and the supervision responsibility of relevant government departments such as NMPA should be strengthened.

Text analysis of China′s family physicians contracted service policy based on policy tools / 中华医院管理杂志

Objective To analyze the policy texts related to the contracted service of family physicians, and probe into the key points and existing problems of the policy in the process of promoting the contracted service of family physicians in China, for the purpose of providing references for the optimization and perfection of the system. Methods A total of 54 relevant policy texts issued by the Central Government from 2011 to 2019 were selected, for establishing a two-dimensional analysis framework based on policy tools and stakeholders.By means of quantitative analysis of policy text and literature research method, we analyzed the relevant policy texts. Results Study of the 54 texts found 52.8% (124/235)mentioned commands and regulatory tool use, 27.2% (64/235) mentioned capacity building tool use, 13.2% (31/235) mentioned information and exhortation tool use, 5.1% (12/235)only mentioned incentive tool use, and 1.7% (4/235) only mentioned system change tool use; while most of them(34.3% and 32.7% )mentioned government and physicians, and only a few(17.6% and 15.4% )mentioned patients and medical entities. Conclusions It is suggested to optimize the policy tools mixture, and increase the use of incentive tools to physicians, and explore new forms of system change tools.It is also proposed to pay more attention to resource allocation of primary medical institutions, and to patient awareness and satisfaction.