ABSTRACT
In 2019, the Chinese government implemented the first round of the National Centralized Drug Procurement (NCDP) pilot (so-called "4 + 7" policy) in mainland China, in which 25 drugs were included. We conducted this study to examine the impacts of NCDP policy on drug utilization and expenditures, and to clarify the main factors contributing to drug expenditure changes. This study used drug purchasing order data from the Centralized Drug Procurement Survey in Shenzhen 2019. Drugs related to the "4 + 7" policy were selected as study samples, including 23 "4 + 7" policy-related varieties and 15 basic alternative drugs. Driving factors for drug expenditures changes were analyzed using A.M. index system analysis (Addis A. & Magrini N.' method). After the implementation of the NCDP policy, the volume of "4 + 7" policy-related varieties increased by 73.8%, among which winning products jumped by 1638.2% and non-winning products dropped by 70.8%; the expenditures of "4 + 7" policy-related varieties decreased by 36.9%. Structure effects (0.47) and price effects (0.78) negatively contributed to the increase in drug expenditures of "4 + 7" policy-related varieties, while volume effects (1.73) had positive influence. NCDP policy successfully decreased drug expenditures of "4 + 7" policy-related varieties with structure effects playing a leading role. However, total drug expenditures were not effectively controlled due to the increasing use of alternative drugs.
Subject(s)
Health Expenditures , Pharmaceutical Preparations , China , Drug Costs , Drug UtilizationABSTRACT
Elderly mental health promotion is an important task in the current "Healthy China Action". This study aims to (a) clarify the psychological pain and suicidal ideation of the Chinese elderly with different parental states, (b) examine the associated factors of psychological pain and suicidal ideation, and (c) examine the relationship between psychological pain and suicidal ideation. A sample of 4622 adults aged 60 years and older were included in this study, from the China's Health-related Quality of Life Survey for Older Adults 2018. Participants with both parents alive demonstrated the heaviest psychological pain, and those with one parent alive observed significantly lowest psychological pain and suicidal ideation. Participants who were single, divorced, or widowed, live in rural areas, had higher education level, had lower family income, suffered from two or more chronic diseases, and had no self-care ability were more likely to experience psychological pain and suicidal ideation. In addition, higher psychological pain significantly associated with the occurrence of suicidal ideation. In China, much more attention should be paid to the mental health condition of the elderly, especially for those with both parents alive. Moreover, the associated factors above should be considered to develop targeted health interventions.
