ABSTRACT
The COVID-19 pandemic has forced governments to impose crippling restrictions on the day-to-day activities of citizens. To contain the virus and lift these restrictions safely, policymakers need to know quickly where the virus is spreading. This has been possible only through widespread testing. Not long after starting largescale testing in the early stages of the pandemic and more recently with a surge of new variants, countries hit a roadblock—the shortage of swabs used in the testing kits due to disruptions in the supply chain caused by COVID-19. This disruption translates to a variable production capacity of the swab suppliers. As a result, when countries order swabs from a swab supplier, their order might not be fully satisfied. Hence, adopting a proper swab inventory management model can help countries better manage COVID-19 testing and avoid widespread shortages of testing supplies. By considering two different swab demand patterns (i.e., stationary and stochastic) and two different production capacity scenarios for the swab supplier (i.e., ample and variable production capacity), we develop four analytical models, in which we consider all combinations of the above demand and capacity scenarios, to derive the optimal swab-procurement policy for a country. Given the rapid change of COVID-19 infection cases and the limited planning period, countries should aim for reactive scheduling. Through a comprehensive numerical study, we also provide guidelines on how countries should optimally react to these changes in the supply and demand of swabs. The research implications for managing inventory with stochastic supplier capacity and uncertain demand in a finite time horizon extend well beyond the application to COVID-19 testing.
ABSTRACT
Background: National Centralized Drug Procurement (NCDP), an ongoing government-led policy starting in 2019 in China, aimed at reducing drug costs. During the implementation of NCDP, healthcare professionals (HCPs) still have a certain degree of concern about the policy, which affects the clinical use of related drugs. Objective: This study aims to assess the level of knowledge, attitude and practice (KAP) of HCPs towards NCDP policy, together with the associated factors that determine their KAP. Methods: A cross-sectional study was conducted between September and November of 2021 in 30 hospitals in Hubei province in Central China. A self-designed online questionnaire including KAP towards NCDP policy was administered to HCPs. Logistic regression analysis was adopted to identify the factors associated with KAP. Results: A Total of, 742 HCPs completed the questionnaires. 43.4% of HCPs had good knowledge, 24.7% had a positive attitude, and 23.7% held good practice. Through multivariate logistic regression analysis, HCPs who are males, pharmacists, with senior professional titles and 6-10 years of professional working experience contributed to a higher knowledge level. Pharmacists and HCPs with good knowledge were more likely to have positive attitudes, while HCPs with higher education were less likely to have positive attitudes. Pharmacists, HCPs who had 11-20 years of professional working experience, worked in medium-size urban areas or had good knowledge were more likely to have good practice. Good practice is also associated with the positive attitude towards the efficacy of centralized-purchased medicines and impacts of NCDP policy. Conclusion: Only a small percentage of HCPs had good KAP towards NCDP policy. Pharmacists showed better KAP than physicians. The positive attitude towards the efficacy of centralized-purchased medicines and impacts of NCDP policy contributed to better practice. High-quality clinical evidence on the therapeutic effects and safety of the centralized-purchased drugs is needed.
ABSTRACT
Across the country, hospitals are buying more sustainable food and passing internal policies in support of sustainable food procurement. This reflective essay describes the results of the sustainable procurement goals and policy of the University of California's five health systems from 2009 to 2021. Based on my observations as a staff person in the University of California and my participation in internal meetings with foodservice and sustainability staff, I discuss the evolution of the University of California's sustainable food procurement policy goals and its definition of "sustainable." I describe staff and programmatic support for purchasing environmentally sustainable food and beverages and the growth of the University of California's sustainable food purchases as a percentage of its hospitals' food budgets. This essay also explores staff debates about the sustainability of sourcing poultry with the label of "no antibiotics ever" after a 2020 COVID-19 outbreak at a poultry processing facility in California that led to the deaths of several workers. These debates about labor and working conditions in poultry supply chains from the five University of California health systems offer insights into ongoing challenges and opportunities for institutional food procurement and policy to change the food system utilizing existing supply chains and third-party certifications and label claims. The University of California's experiences also illustrate the ongoing need for farm-to-institution and farm-to-hospital efforts to better integrate values around working conditions in supply chains into sustainable procurement goals.