With the continuous progress and development of the medical and health industry, drug procurement has gradually attracted more attention, and the drug bidding and procurement model in China is in a stage of gradual improvement. In this article, the historical evolution of drug centralized bidding and procurement policy in China is briefly introduced. By analyzing the current drug centralized bidding and procurement policy implemented in China, issues such as difficulty reasonably determining “quantity” in quantity procurement, lack of drug effective supervision of procurement policy, incomplete drug catalog procurement, and out-of-network procurement were found. Some possible feasible suggestions are also put forward, aiming at providing reference and ideas for further improvement of drug centralized bidding and procurement policy under the new situation, so as to ensure safety of drugs and benefit the people.
Evidence-informed decision making is one of the most common, objective and important health policy research methods used by policy makers. Its purpose is to promote the application and dissemination of research knowledge on health policy and systems to change traditional and subjective models of health policy making in order to improve national and regional health systems. Three elements will influence the effectiveness of health policy making:research evidence, available health resources and the value of policy formulation. This paper introduces some pragmatic evidence-based approaches, especially systematic reviews, priority setting and a combined approach matrix (CAM). Systematic reviews have a b impact on the decision process for policy makers. We hope that the application and development of evidence-informed methods will increase in China’s health policy research.
ObjectivesTo evaluate the intention of having a second child among females of childbearing age after the implementation of China’s universal two-child policy so as to provide evidence for further studies.MethodsCNKI, VIP, WanFang Data, CSSCI, PubMed, EMbase and ScienceDirect databases were electronically searched to collect cross-sectional studies on the intention of females of childbearing age to have a second child from January 1st, 2016 to August 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using R software.ResultsA total of 15 studies involving 18 820 cases were included. The results of meta-analysis showed that the fertility rate for the second child of females of childbearing age was 0.42 (95%CI 0.37 to 0.47), and the result was stable. Subgroup analysis showed that the fertility rate of second child in eastern region was higher than that in western region (0.44 vs. 0.40), in rural areas was higher than that in non-rural areas (0.46 vs. 0.35), females aged 18 to 34 was higher than those aged above 35 (0.49 vs. 0.29), and non-working females was higher than that among working females (0.48 vs. 0.40). The fertility rate of the sex of the first child being female was higher than the sex of the first child was male (0.48 vs. 0.39). The fertility rate of the couple who were both the non-only child was higher than the couple who were both the only child and who was only child while the other was non-only child (0.46 vs. 0.41 vs. 0.40).ConclusionsSince the implementation of the “universal two-child policy” in China, the fertility rate of females of childbearing age with the intention of having a second child is lower, especially those females who are from the western regions and non-rural areas, aged above 35 and the sex of the first child is male and non-dual-non-couples. Due to the quantity and quality of the included studies, more high quality studies are required to verify the above conclusions in future.
In the context of actively coping with aging, China has introduced a series of health care integration policies. Using the advocacy coalition framework theory, this paper aims to analyze the process of health care integration policy changes in China from three dimensions: policy beliefs, external events and policy learning. The policy subsystem of health care integration in China includes two coalitions: top-down cascade promotion and bottom-up absorption and radiation. External events and policy learning triggered policy change, where policy learning included endogenous learning within the coalition and exogenous learning between the coalitions. A policy impasse occurs when the two advocacy coalitions are at odds, and policy brokers and professional forums can get rid of the policy impasse. In the process of policy change in China’s health care integration, the two major advocacy coalitions have reached a certain consensus. It is recommended to alleviate the problems in the integration of health care by strengthening the external factors in the change of health care policy, enhancing the policy learning in the change of health care policy, and making full use of the information resources in the change of health care policy, so as to promote the high-quality development of the integration of health care.
As the implementation of the high-quality development policy of public hospitals is faced with the problems of diversified environment and the coordination of execution of complex actors, the network structure has changed from the closed resistance type to the open competition type. At present, China’s high-quality development policy of public hospitals needs to improve the policy system and refine the top-level design; strengthen the executive power of network entities and innovate the joint governance mechanism; optimize the structure of policy tools to improve the resilience and flexibility of the network; implement the performance evaluation mechanism and strengthen supervision. This article is based on policy network theory and provides an in-depth analysis of the current high-quality development policy texts for public hospitals in China, with the aim of providing suggestions for policy development
In order to understand the latest progress of health decision support system (HDSS) construction, grasp the law of HDSS development and adopt the international advanced experience, this paper took Australia for example, presented a comparative analysis on the construction practices, including the contents, features and system functions of national construction guidelines for HDSS in different periods, and showed the integral development level of Australia HDSS was still in the exploratory stage, and its construction goal, function orientation and construction mechanism got improved gradually with the deep development of public health information. Additionally, to assure the accuracy and safety of HDSS function, Australia has been laying stress on the standard specification construction and system function authentication.
ObjectivesTo analyze the characteristics six types of cross-regional cancer patients and their medical behavior in Beijing.MethodsWe described the characteristics of cross-regional patients, analyzed the differences between cross-regional and local patients, and identified the key factors by analyzing the influencing factors of patient's cross-regional behavior to factors by using binary logistic regression model.ResultsCompared with local patients, cross-regional cancer patients had the following characteristics: consisting primarily of young and middle-aged workforce, simpler disease status and those more inclined to choose special hospital and surgical treatment.ConclusionsPromoting the construction of regional oncology medical center can meet the needs of cross-regional patients and relieve the pressure of medical treatment in large cities caused by cross-regional medical treatment behavior.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
Health insurance system has been proved to be an effective way to promote the quality of health service in many countries. However, how to control health expenditure under health insurance system remains a problem to be resolved. Some developed countries like UK, Canada and Sweden linked their health technology assessment results with decision making and health insurance management, and made prominent achievements in both expenditure control and quality improvement. China is carrying out its health system reform and running a new health insurance project. Using the experiences of other countries is undoubtedly of great importance in developing and managing our health insurance system.
Objective To discuss the epidemiological characteristics of young and middle-aged people infected with COVID-19 in Gansu province under the new epidemic policy. Methods A total of 1800 people were collected from two tertiary hospitals in Gansu province from November 8, 2022 to January 28, 2023. The vaccination status, nucleic acid antigen detection, the specific time of infection, main symptoms and severity of the disease were investigated. Results Among 1800 participants, 1685 (93.6%) were vaccinated and 1565 (86.9%) were infected with COVID-19. Among the 1565 infected persons, 523 (33.4%) completed both nucleic acid and antigen testing, 382 (24.4%) completed nucleic acid testing, 490 (31.3%) completed antigen testing, 170 (10.9%) received IgG testing. 1490 (95.2%) were slight ill, 75 (4.8%) were critical ill, and 96 (6.1%) were hospitalized, and no one died. In 2022, 92 cases (5.9%) were infected in the first half of November, 141 cases (9.1%) in the second half of November, 630 cases (40.3%) in the first half of December, and 553 cases (35.4%) in the second half of December. 109 cases (7.0%) were infected in the first half of January, 38 cases (2.2%) in the second half of January, and 2 cases (0.1%) in the first half of February of 2023. and no cases in the second half of February. Among the 1565 infected persons, 825 (52.7%) had respiratory symptoms, 293 (18.7%) had gastrointestinal symptoms, 257 (16.4%) had autonomic disorders, 140 (8.9%) had other symptoms such as decreased smell and taste, and 48 (3.3%) had no symptoms after infection. Conclusions The vaccination rate of young and middle-aged people in Lanzhou city of Gansu Province is high. Since the new policy, the infection rate of the novel coronavirus among young and middle-aged people is high, the number of antigen tests is more than nucleic acid tests, most of the infected patients are slight, with fewer critical patients, and the hospitalization rate is low. The peak of infection occurred in early December 2022, and the infection rate was basically zero by February 2023. The main symptoms of COVID-19 infection are mainly respiratory tract, followed by digestive tract and autonomic nervous system disorders, and few patients are completely asymptomatic.