Status quo analysis on non-immunization program vaccination among children in Shanghai / 上海预防医学

Objective To investigate the status of non-immunization program vaccination among children in Shanghai. Methods Three districts were randomly selected for investigation in Shanghai.In the survey area, probability proportional to size sampling method was used to investigate the vaccination situation of non-immunization program and willingness to accept vaccination service in children aged 0-6 years old. Results A total of 416 children aged 0-6 years and their parents were investigated, 93.27%(388) of children received 1 dose or more of non-immunization program vaccines and 36.54% of children received 5 or more non-immunization program vaccines.The coverage of haemophilus influenzae type b conjugate vaccine, 13-valent pneumococcal conjugate vaccine, enterovirus 71 inactivated vaccine, oral rotavirus vaccine and influenza vaccine were 25.00%, 20.91%, 57.45%, 53.37% and 14.42%, respectively.64.95% of parents decided to vaccinate their children with non-immunization program vaccines because of the recommendation of vaccination staff.And 85.58% of parents requested vaccination staff to inform them or make appointments with non-immunization program vaccination.84.62% of parents could accept the charge for vaccination service. Conclusion In Shanghai, the proportion of children receiving multiple non-immunization program vaccination is relatively low and their parents′ demand for vaccination notification services is high.Vaccination staff should be encouraged to actively provide non-immunization program vaccination services, meeting the diverse needs of the public.

Projection of future pharmacy service fees using the dispensing claims in hospital and clinic outpatient pharmacies: national health insurance database between 2006 and 2012.

BACKGROUND: Predicting pharmacy service fees is crucial to sustain the health insurance budget and maintain pharmacy management. However, there is no evidence on how to predict pharmacy service fees at the population level. This study compares the status of pharmacy services and constructs regression model to project annual pharmacy service fees in Korea. METHODS: We conducted a time-series analysis by using sample data from the national health insurance database from 2006 and 2012. To reflect the latest trend, we categorized pharmacies into general hospital, special hospital, and clinic outpatient pharmacies based on the major source of service fees, using a 1% sample of the 2012 data. We estimated the daily number of prescriptions, pharmacy service fees, and drugs costs according to these three types of pharmacy services. To forecast pharmacy service fees, a regression model was constructed to estimate annual fees in the following year (2013). The dependent variable was pharmacy service fees and the independent variables were the number of prescriptions and service fees per pharmacy, ratio of patients (≥ 65 years), conversion factor, change of policy, and types of pharmacy services. RESULTS: Among the 21,283 pharmacies identified, 5.0% (1064), 4.6% (974), and 77.5% (16,340) were general hospital, special hospital, and clinic outpatient pharmacies, respectively, in 2012. General hospital pharmacies showed a higher daily number of prescriptions (111.9), higher pharmacy service fees ($25,546,342), and higher annual drugs costs ($215,728,000) per pharmacy than any other pharmacy (p <  0.05). The regression model to project found the ratio of patients aged 65 years and older and the conversion factor to be associated with an increase in pharmacy service fees. It also estimated the future rate of increase in pharmacy service fees to be between 3.1% and 7.8%. CONCLUSIONS: General hospital outpatient pharmacies spent more on annual pharmacy service fees than any other type of pharmacy. The forecast of annual pharmacy service fees in Korea was similar to that of Australia, but not that of the United Kingdom.

Costs of examinations performed in a hospital laboratory in Chile / Custos de exames em um laboratório clínico hospitalar no Chile / Costos de exámenes en un laboratorio clínico hospitalario de Chile

ABSTRACT Objective: To determine the total average costs related to laboratory examinations performed in a hospital laboratory in Chile. Method: Retrospective study with data from July 2014 to June 2015. 92 examinations classified in ten groups were selected according to the analysis methodology. The costs were estimated as the sum of direct and indirect laboratory costs and indirect institutional factors. Results: The average values obtained for the costs according to examination group (in USD) were: 1.79 (clinical chemistry), 10.21 (immunoassay techniques), 13.27 (coagulation), 26.06 (high-performance liquid chromatography), 21.2 (immunological), 3.85 (gases and electrolytes), 156.48 (cytogenetic), 1.38 (urine), 4.02 (automated hematological), 4.93 (manual hematological). Conclusion: The value, or service fee, returned to public institutions who perform laboratory services does not adequately reflect the true total average production costs of examinations.

RESUMO Objetivo: Determinar os custos médios totais associados à realização de exames laboratoriais em um laboratório clínico hospitalar no Chile. Método: Estudo retrospectivo com informações de julho de 2014 a junho de 2015. Foram selecionados 92 exames classificados em dez grupos de acordo com a metodologia de análise. Os custos foram estimados como a soma dos custos diretos e indiretos de laboratório e fatores institucionais indiretos. Resultados: Os valores médios dos custos foram obtidos de acordo com o grupo de exames (em dólares): 1,79 (química clínica), 10,21 (técnicas de imunoensaio), 13,27 (coagulação), 26,06 (cromatografia líquida de alta resolução), 21,2 (imunológicos), 3,85 (gases e eletrólitos), 156,48 (citogenéticos), 1,38 (urina), 4,02 (hematológicos automáticos), 4,93 (hematológicos manuais). Conclusão: O valor retornado às instituições públicas, ou taxas de serviço, que prestam serviços laboratoriais não refletem adequadamente os custos totais reais da produção de exames.

RESUMEN Objetivo: determinar los costos medios totales asociados a la realización de exámenes de laboratorio en un laboratorio clínico hospitalario de Chile. Método: estudio retrospectivo con información del período julio 2104 a junio 2015. Se seleccionaron 92 exámenes clasificados en diez grupos según la metodología de análisis. Los costos se estimaron como la suma de costos directos e indirectos de laboratorio y factores indirectos institucionales. Resultados: se obtuvieron los valores promedio para los costos según grupo de exámenes (en dólares): 1,79 (química clínica), 10,21 (técnicas de inmunoensayos), 13,27 (coagulación), 26,06 (cromatografía líquida de alta resolución), 21,2 (inmunológicos), 3,85 (gases y electrolitos), 156,48 (citogenéticos), 1,38 (orina), 4,02 (hematológicos automatizados), 4,93 (hematológicos manuales). Conclusión: el valor que retorna a las instituciones públicas, o arancel por servicio, que prestan servicios de laboratorio no refleja adecuadamente los verdaderos costos medios totales de producción de exámenes.

Pharmacy Service Fee Reform:Connotation Analysis and Policy Selection / 中国药房

OBJECTIVE:To provide policy selection for pharmacy service fee reform in China under New Health Reform that drug addition in public hospitals is abolished completely throughout the country. METHODS:The situation and general characteristics of pharmacy service fee reform were summarized since New Health Reform. The multi-dimension of pharmacy service fee was analyzed to define the connotation of pharmacy service fee again. The solution to pharmacy service fee and clinical pharmaceutical care fee reform were put forward. RESULTS:There were many theoretical discussions on the establishment of pharmacy service fee since New Medical Reform,but no achievements had been made in reform practice. The connotation of pharmacy service fee should be subdivided,and the"pharmacy service fee"should be used as the content of the cost compensation for the public service provided by the hospital;"clinical pharmaceutical care fee"should be set up as the cost compensation content of the professional technical service;according to the different natures of the service,the corresponding policy could be designed. CONCLUSIONS:It is suggested that"pharmacy service fee",as lump sum fee,could be solved in the dynamic adjustment of medical service price;"clinical pharmaceutical care fee"should be approved independently and included in the standard charge items according to the individual project.At the same time,local pilot is encouraged,the charge of clinical pharmaceutical care is included in the national charge catalogue,and national standards are studied and formulated. The performance management model of pharmaceutical personnel can be adjusted to promote the healthy development of pharmacy subject.

An evaluation study on family doctors′ income level and policy incentive effect in Changning / 中华医院管理杂志

Objective To evaluate the motivation effect of family doctors′ contracting service and health insurance compensation mechanism from the perspective of income change and income satisfaction of family doctors .Methods The situation about salary compensation plan reform and the change of income level and structure were learnt from interviews on the management personnel and questionnaire surveys of family doctors in 2013 and 2016 .The data were subject to descriptive statistics .Results The proportion of family doctors earning between 8000 and 10000 yuan in 2016 rose to 67.16％ (90/134 ) from 18.18％ (26/143 ) in 2013.11.72％ (15/128 ) of family doctors′contracting service fee amounted to over 50％ of their income. The number of family doctors who were dissatisfied with their income has fallen by 28.52％ .There were still 51.90％ (68/131)of the family doctors who were not satisfied with their income and 24.64％ (34/138)of them held the incentives of performance appraisal as a failure .Conclusions The income of family doctors has been greatly increased in the last three years.Contracting service fee plays a key role in motivating these doctors , but three risks also need to be prevented in the process of further reform .

Exploration of Pharmaceutical Service Fee Implementation and Online Pharmaceutical Service Prospect Based on a Questionnaire Survey / 中国药师

Objective: To investigate the public opinion on pharmaceutical service and explore the implementation of pharmaceutical service fee and the prospect of online pharmaceutical service in our country.Methods: Questionnaires which related to pharmaceutical service fee and online pharmaceutical service were distributed to patients and their relatives or friends, and then recycled.The data including the recycling of questionnaires, information of respondents and answers to the questions were statistically analyzed.Results: Totally 63.8% respondents considered pharmaceutical service fee was reasonable and the fee should be borne by the government finance and health care insurance.Totally 85.5% respondents thought launching online pharmaceutical service was necessary, which included online retails of medicine, consultation, medication guidance, decoction of Chinese traditional medicines, medicine delivery and so on, especially pharmacy consultation.Conclusion: Outpatients have high demands of pharmaceutical service and most of them accept online pharmaceutical service with different understandings.Pharmaceutical service fee is an inevitable trend in the development of pharmaceutical industry.More publicity and guidance should be given to improve people's acceptance of pharmaceutical service and relevant cost.Relevant departments should take full advantages of Internet and provide diversified pharmaceutical service.

The effects of pharmaceutical service fee policy on the county-level public hospitals:A case study of five counties( districts) in Chongqing / 中国卫生政策研究

It is an important content for breaking the mechanism ofdrug-supplement-medicine that the com-pensation system of drug zero price rate should be improved in public hospitals. In this paper, we collect random sampling survey data of the implementation of zero-difference drug sales before and after which is performed in People's hospital and Traditional Chinese Medicine hospital in five counties( districts) of Chongqing city. Based on the data, the status and effects of pharmaceutical service Fee policy on the county-level public hospitals in Chongqing was evaluated by combining quantitative description with qualitative analysis in the research methods. The study shows that the compensation policy design of pharmaceutical service fee is reasonable in Chongqing city and its posi-tive effect is obvious. It has also an obvious effect on the reduction of the average outpatient and hospitalization drug expense;but it's not conducive to arouse the enthusiasm of public hospital deepening reform of the initiative because the actual compensation rate of pharmaceutical service fee is low, and the public hospital comprehensive compensa-tion mechanism and operation mechanism reform are lagging behind.

Clinical pharmaceutical care in Japan and its inspirations / 中华医院管理杂志

The clinical pharmaceutical care in Japan is patient-centered and professional .Their policies of pharmaceutical service fee encourage clinical pharmaceutical care development , and embody values of pharmacists as well .The pharmaceutical service management in Japan indicates its attention on practical outcomes , serving as a useful reference for China in both service mode and management policies .

Análisis del recupero de costos por cobro a terceros pagadores en hospitales públicos de la provincia de Tucumán, Argentina / Analysis of the recovery of costs for collection from third parties in public hospitals in the province of Tucumán, Argentina

INTRODUCCION: La escasa información analizada y el desconocimiento del perfil epidemiológico que solicita el servicio del hospital público a un tercer pagador generó el desarrollo de la presente investigación. Existe un deterioro de la relación hospital-tercer pagador. LA falta de claridad en esta relación y de información confiable hace que las decisiones de utilización de lo recaudado no siempre sean las acertadas. La provisión de servicios de salud constituye una acción asocial y económica.OBJETIVO: Analizar la relación existente entre los terceros pagadores y los hospitales del interior de la provincia de Tucumán, teniendo en cuenta el perfil de recupero de costos y el perfil epidemiológico de la demanda.METODOS: Se utilizó un diseño descriptivo, analítico y de corte transversal con análisis de asociación mediante el el test ANOVA. El estudio se desarrolló en los hospitales pertenecientes a la red de prestadores públicos de salud, dependiente del Sistema Provincial de Salud (Ministerio de Salud Pública).RESULTADOS: El análisis reflejó un perfil epidemiológico particular con un perfil de prestaciones de esas mismas características. También quedaron evidenciadas falencias en la captación de los pacientes y en el registro de los datos epidemiológicos. Pudo observarse, asimismo, que la desfinanciación por parte de algunos terceros pagadores obliga al Estado a transferir partidas para compensar y permitir el funcionamiento de los hospitales de referencia.CONCLUSIONES: Las coincidencias del perfil epidemiológico con el perfil de prestaciones permiten elaborar una modulación como base para realizar convenios. Los resultados de esta investigación pueden favorecer la planificación sanitaria y promover nuevos mecanismos de acción en cuanto a los procedimientos de facturación, cobro y compensación.

INTRODUCTION: There is scarce information and a wide ignorance of the epidemiological profile of a member of a third-party payer requesting the service of public hospitals. The relationship between third-party payers and hospitals is getting worse. The lack of clarity and reliable information leads some times to wrond decisions. The provision of health services is a social and economic action.OBJECTIVE: To analyze the relationship between third-party payers and hospitals within the province of Tucumán in terms of cost-recovery profile and the epidemiological profile of demand.METHODS: A descriptive, analytical, cross-sectional study was conducted, with association analysis through ANOVA test. It took place in hospitals belonging to the network of public health providers, under the Provincial Health System (SIPROSA).RESULTS: The analysis reflected a particular epidemiological profile and a benefit profile with the same features. It also showed weaknesses in the recruitment of patients and the registration of epidemiological data. Due to funding by some third-party payers, the state has to transfer money to guarantee the functioning of hospitals.CONCLUSIONS: Matching the epidemiological and benefit profiles, it may be possible to reach a modulation as basis for agreements. The results of this reserch can promote health planning as well as new mechanisms regarding procedures about billing, collection and compensation.

Análisis del recupero de costos por cobro a terceros pagadores en hospitales públicos de la provincia de Tucumán, Argentina / Analysis of the recovery of costs for collection from third parties in public hospitals in the province of Tucumán, Argentina

INTRODUCCION: La escasa información analizada y el desconocimiento del perfil epidemiológico que solicita el servicio del hospital público a un tercer pagador generó el desarrollo de la presente investigación. Existe un deterioro de la relación hospital-tercer pagador. LA falta de claridad en esta relación y de información confiable hace que las decisiones de utilización de lo recaudado no siempre sean las acertadas. La provisión de servicios de salud constituye una acción asocial y económica.OBJETIVO: Analizar la relación existente entre los terceros pagadores y los hospitales del interior de la provincia de Tucumán, teniendo en cuenta el perfil de recupero de costos y el perfil epidemiológico de la demanda.METODOS: Se utilizó un diseño descriptivo, analítico y de corte transversal con análisis de asociación mediante el el test ANOVA. El estudio se desarrolló en los hospitales pertenecientes a la red de prestadores públicos de salud, dependiente del Sistema Provincial de Salud (Ministerio de Salud Pública).RESULTADOS: El análisis reflejó un perfil epidemiológico particular con un perfil de prestaciones de esas mismas características. También quedaron evidenciadas falencias en la captación de los pacientes y en el registro de los datos epidemiológicos. Pudo observarse, asimismo, que la desfinanciación por parte de algunos terceros pagadores obliga al Estado a transferir partidas para compensar y permitir el funcionamiento de los hospitales de referencia.CONCLUSIONES: Las coincidencias del perfil epidemiológico con el perfil de prestaciones permiten elaborar una modulación como base para realizar convenios. Los resultados de esta investigación pueden favorecer la planificación sanitaria y promover nuevos mecanismos de acción en cuanto a los procedimientos de facturación, cobro y compensación.

INTRODUCTION: There is scarce information and a wide ignorance of the epidemiological profile of a member of a third-party payer requesting the service of public hospitals. The relationship between third-party payers and hospitals is getting worse. The lack of clarity and reliable information leads some times to wrond decisions. The provision of health services is a social and economic action.OBJECTIVE: To analyze the relationship between third-party payers and hospitals within the province of Tucumán in terms of cost-recovery profile and the epidemiological profile of demand.METHODS: A descriptive, analytical, cross-sectional study was conducted, with association analysis through ANOVA test. It took place in hospitals belonging to the network of public health providers, under the Provincial Health System (SIPROSA).RESULTS: The analysis reflected a particular epidemiological profile and a benefit profile with the same features. It also showed weaknesses in the recruitment of patients and the registration of epidemiological data. Due to funding by some third-party payers, the state has to transfer money to guarantee the functioning of hospitals.CONCLUSIONS: Matching the epidemiological and benefit profiles, it may be possible to reach a modulation as basis for agreements. The results of this reserch can promote health planning as well as new mechanisms regarding procedures about billing, collection and compensation.