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Evaluation, in three provinces, of the introduction and impact of China's National Essential Medicines Scheme

Bulletin of the World Health Organization, 2013-03, Vol.91 (3), p.184-194 [Peer Reviewed Journal]

2014 INIST-CNRS ;Copyright World Health Organization Mar 2013 ;(c) World Health Organization (WHO) 2013. All rights reserved. 2013 ;This work is licensed under a Creative Commons Attribution 3.0 International License. ;ISSN: 0042-9686 ;EISSN: 1564-0604 ;DOI: 10.2471/blt.11.097998 ;PMID: 23476091 ;CODEN: BWHOA6

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Title:
Evaluation, in three provinces, of the introduction and impact of China's National Essential Medicines Scheme
Author: YANG LI ; CUI YING ; GUO SUFANG ; BRANT, Philippa ; BIND, Li ; HIPGRAVE, David
Subjects: Attitude of Health Personnel ; Attitude to Health ; Biological and medical sciences ; China ; China (People's Republic) ; Chronic Disease ; Chronic illnesses ; Clinics ; Cost ; Cost Control - methods ; Drug Costs - standards ; Drug Costs - trends ; Drugs ; Evaluation Studies as Topic ; Financing, Government ; Focus groups ; General aspects ; Government purchasing ; Health care expenditures ; Health care policy ; Health Care Reform - economics ; Health Care Reform - trends ; Health facilities ; Health insurance ; Health Policy & Services ; Hospitals ; Humans ; Interviews as Topic ; Medical sciences ; Medical service ; Medicine ; Miscellaneous ; National Health Programs - economics ; National Health Programs - organization & administration ; National Health Programs - trends ; Patients ; Pharmaceutical industry ; Physicians ; Physicians - economics ; Physicians - trends ; Practice Patterns, Physicians' - economics ; Practice Patterns, Physicians' - trends ; Prescription drugs ; Prescription Drugs - economics ; Prescription Drugs - standards ; Prescription Drugs - supply & distribution ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative Research ; Questionnaires ; Rural Health Services - economics ; Rural Health Services - organization & administration ; Rural Health Services - trends ; Salaries and Fringe Benefits - trends ; Studies ; Villages ; Wage & price controls ; Workloads
Is Part Of: Bulletin of the World Health Organization, 2013-03, Vol.91 (3), p.184-194
Description: To evaluate implementation of the National Essential Medicines Scheme (NEMS) in rural China. Two rural counties/districts in each of three provinces where NEMS had been implemented were surveyed. Information was collected from NEMS staff at the province, county/district, township and village levels; patients with chronic disease were also interviewed. Service provision, finances, prescriptions, inpatient records and the expenditures of patients with certain diagnoses were investigated in township hospitals and village clinics. The results were compared with the corresponding data recorded before NEMS was introduced. Following the introduction of NEMS, drug procurement in each study location was systematized. Total drug costs declined. This, and improved prescribing, reduced the costs of outpatient and inpatient care and led, apparently, to increased uptake of health services. However, the prices of some drugs had increased and the availability of others had declined. The compensation of health-care providers for NEMS-related reductions in their incomes had been largely ineffective. As a result of the introduction of NEMS, health facilities relied more on public financing. Many health-care providers complained about higher workloads and lower incomes. Although it was well conceived, the introduction of NEMS into China's decentralized, fee-for-service system of health care has not been straightforward. It has highlighted the problems associated with attempts to modernize health care and health financing for patients' benefit. Sustainable mechanisms to compensate health-care providers for lost income are needed to ensure that NEMS is a success.
Publisher: Genève: Organisation mondiale de la santé
Language: English;Portuguese
Identifier: ISSN: 0042-9686
EISSN: 1564-0604
DOI: 10.2471/blt.11.097998
PMID: 23476091
CODEN: BWHOA6
Source: SciELO
GFMER Free Medical Journals
MEDLINE
PubMed Central
ProQuest Central
DOAJ Directory of Open Access Journals

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Evaluation, in three provinces, of the introduction and impact of China's National Essential Medicines Scheme

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