The effect of essential medicines programme on rational use of medicines in China.

Abstract:

OBJECTIVE:Irrational use of medicines is a serious problem in China and has been the primary target of China's national essential medicines programme (NEMP). The aim of this study was to evaluate the effect of the NEMP on rational use of medicines in China. METHODS:A nationwide sample of 3 76 700 prescriptions written by primary care providers from 2007 to 2011 was obtained following a multistage sampling process. Six prescribing indicators were measured: average number of drugs prescribed per prescription, average expenditure per prescription, percentage of prescriptions with antibiotics, with injections, with two or more antibiotics and with corticosteroids. The pre-post with control study design and the difference-in-difference (DID) methodology were employed to evaluate the effect of NEMP. RESULTS:Prescriptions from primary care institutions with the NEMP implementation were better than those without NEMP implementation. Adjusting for the institution's sizes, ownership, economic geographic regions and the year of NEMP implementation, the DID estimator was statistically significant in all prescribing indicators except for the percentage of prescriptions with injection. The number of drugs per prescription decreased by 0.2 per prescription [95% confidence interval (CI): -0.3, -0.1] after the NEMP was implemented; the percentages of prescriptions with antibiotics, with corticosteroids and with two or more antibiotics decreased by 7% (95% CI: -10, -4), 1% (95% CI: -2, 0) and 2% (95% CI: -3, 0), respectively; and the average expenditure per prescription decreased by eight Renminbi Yuan (95% CI: -14, -2). The effect of NEMP on reducing irrational prescribing was greater in public institutions than in private institutions (P < 0.05). CONCLUSIONS:China's NEMP is effective in promoting rational use of medicines, and the effect is greater in public institutions than in private institutions. However, the irrational use is still high, pointing to the need for further reforms to tackle the underlying causes, such as clinical guidelines and patient education.

journal_name

Health Policy Plan

authors

Gong Y,Yang C,Yin X,Zhu M,Yang H,Wang Y,Li Y,Liu L,Dong X,Cao S,Lu Z

doi

10.1093/heapol/czv008

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

21-7

issue

1

eissn

0268-1080

issn

1460-2237

pii

czv008

journal_volume

31

pub_type

杂志文章
  • Socioeconomic inequality in premiums for a community-based health insurance scheme in Rwanda.

    abstract::Community-based health insurance (CBHI) has gained popularity in many low- and middle-income countries, partly as a policy response to calls for low-cost, pro-poor health financing solutions. In Africa, Rwanda has successfully implemented two types of CBHI systems since 2005, one of which with a flat rate premium (200...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa135

    authors: Chirwa GC,Suhrcke M,Moreno-Serra R

    更新日期:2020-12-02 00:00:00

  • The cost of safe sex: estimating the price premium for unprotected sex during the Avahan HIV prevention programme in India.

    abstract::There is some evidence that female sex workers (FSWs) receive greater earnings for providing unprotected sex. In 2003, the landscape of the fight against HIV/AIDS dramatically changed in India with the introduction of Avahan, the largest HIV prevention programme implemented globally. Using a unique, cross-sectional bi...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czz100

    authors: Quaife M,Lépine A,Deering K,Terris-Prestholt F,Beattie T,Isac S,Paranjape RS,Vickerman P

    更新日期:2019-12-01 00:00:00

  • Why should the poor insure? Theories of decision-making in the context of health insurance.

    abstract::Increasingly, low- and middle-income countries are looking to community-based health insurance (CBHI) as a means of ensuring access to health care for the poor. However, little evidence exists about the determining factors that affect poor individuals' insurance decisions. This article reviews the economic and social ...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czh050

    authors: Schneider P

    更新日期:2004-11-01 00:00:00

  • Intergovernmental health policy decisions in Brazil: cooperation strategies for political mediation.

    abstract::The advantages of established intergovernmental decision-making arenas for the implementation of health policies in decentralized settings are not well known. This paper presents the case of the joint health management committee, known as the Tripartite Committee, created to formalize intergovernmental decisions about...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czm004

    authors: Miranda AS

    更新日期:2007-05-01 00:00:00

  • Demand for private healthcare in a universal public healthcare system: empirical evidence from Sri Lanka.

    abstract::This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal pub...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx085

    authors: Pallegedara A,Grimm M

    更新日期:2017-11-01 00:00:00

  • Allocating scarce financial resources for HIV treatment: benchmarking prices of antiretroviral medicines in Latin America.

    abstract::Public sector price analyses of antiretroviral (ARV) medicines can provide relevant information to detect ARV procurement procedures that do not obtain competitive market prices. Price benchmarks provide a useful tool for programme managers and policy makers to support such planning and policy measures. The aim of the...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs011

    authors: Wirtz VJ,Santa-Ana-Tellez Y,Trout CH,Kaplan WA

    更新日期:2012-12-01 00:00:00

  • Review of corruption in the health sector: theory, methods and interventions.

    abstract::There is increasing interest among health policymakers, planners and donors in how corruption affects health care access and outcomes, and what can be done to combat corruption in the health sector. Efforts to explain the risk of abuse of entrusted power for private gain have examined the links between corruption and ...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czm048

    authors: Vian T

    更新日期:2008-03-01 00:00:00

  • Do home pregnancy tests bring women to community health workers for antenatal care counselling? A randomized controlled trial in Madagascar.

    abstract::Task-shifting the provision of pregnancy tests to community health workers (CHWs) in low-resource settings has the potential to reach significantly more underserved women at risk of pregnancy with essential reproductive health services. This study assessed whether an intervention to supply CHWs with home pregnancy tes...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czz080

    authors: Comfort AB,Juras RC,Bradley SEK,Ranjalahy Rasolofomanana J,Noeliarivelo Ranjalahy A,Harper CC

    更新日期:2019-10-01 00:00:00

  • Cost-effectiveness of strategies to reduce mother-to-child HIV transmission in Mexico, a low-prevalence setting.

    abstract:OBJECTIVE:To estimate and compare the cost-effectiveness of selected interventions to reduce mother-to-child transmission (MTCT) of HIV in Mexico. METHODS:A spreadsheet-based model was used to examine five scenarios, each estimated using both zidovudine (ZDV) and nevirapine (NVP). Scenarios differ according to coverag...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czg035

    authors: Rely K,Bertozzi SM,Avila-Figueroa C,Guijarro MT

    更新日期:2003-09-01 00:00:00

  • A scoping review of cost benefit analysis in reproductive, maternal, newborn and child health: What we know and what are the gaps?

    abstract::Growing evidence suggests that early life investments in health are associated with improved human capital and economic outcomes. Various recent global studies have simulated the expected economic returns from alternative packages of interventions in reproductive, maternal, newborn and child health (RMNCH). However, v...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czw078

    authors: Maitra C,Hodge A,Jimenez Soto E

    更新日期:2016-12-01 00:00:00

  • Toward a grounded theory of why some immunization programmes in sub-Saharan Africa are more successful than others: a descriptive and exploratory assessment in six countries.

    abstract::The question of why some immunization programmes in sub-Saharan Africa are more successful than others is an intriguing one, but not one that is frequently raised or investigated. Borrowing techniques from both performance benchmarking and positive deviance inquiry, we explored this question in six countries. We first...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czn028

    authors: Naimoli JF,Challa S,Schneidman M,Kostermans K

    更新日期:2008-11-01 00:00:00

  • 'Seeking affluent neighbourhoods?' a time-trend analysis of geographical distribution of hospitals in the Megacity of Tehran.

    abstract:Objective:Access to hospitals in megacities in low and middle income countries might be hampered by travel barriers and distance. We assessed the 'inverse care law' hypothesis: whether hospitals tended to be built in the relatively better-off areas through the time. Methods:A longitudinal time-series study (1966 to 20...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw172

    authors: Chavehpour Y,Rashidian A,Raghfar H,Emamgholipour Sefiddashti S,Maroofi A

    更新日期:2017-06-01 00:00:00

  • Potential savings from generic prescribing and generic substitution in South Africa.

    abstract::Generic prescribing and generic substitution are mechanisms for reducing the cost of drugs. The purpose of this study was to assess the extent to which generic prescribing by private medical practitioners and generic substitution by private pharmacists is practised in South Africa and to estimate the potential savings...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/11.2.198

    authors: Karim SS,Pillai G,Ziqubu-Page TT,Cassimjee MH,Morar MS

    更新日期:1996-06-01 00:00:00

  • Insured yet vulnerable: out-of-pocket payments and India's poor.

    abstract::Protecting households from high out-of-pocket (OOP) payments for health care is an important health system goal. High OOP payments can push households into poverty and make them vulnerable to catastrophic health expenditures. This study, based in India, aims to: (a) estimate OOP payments for health and related impover...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr029

    authors: Shahrawat R,Rao KD

    更新日期:2012-05-01 00:00:00

  • Health and economic benefits of scaling up a home-based neonatal care package in rural India: a modelling analysis.

    abstract::Approximately 900 000 newborn children die every year in India, accounting for 28% of neonatal deaths globally. In 2011, India introduced a home-based newborn care (HBNC) package to be delivered by community health workers across rural areas. We estimate the disease and economic burden that could be averted by scaling...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv113

    authors: Nandi A,Colson AR,Verma A,Megiddo I,Ashok A,Laxminarayan R

    更新日期:2016-06-01 00:00:00

  • Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia.

    abstract::There is a large body of evidence that user fees in the health sector create exclusion. Health equity funds attempt to improve access to health care services for the poorest by paying the provider on their behalf. This paper reviews four hospital-based health equity funds in Cambodia and draws lessons for future opera...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czm015

    authors: Noirhomme M,Meessen B,Griffiths F,Ir P,Jacobs B,Thor R,Criel B,Van Damme W

    更新日期:2007-07-01 00:00:00

  • Effect of a prospective payment method for health facilities on direct medical expenditures in a low-resource setting: a paired pre-post study.

    abstract::Almost all sub-Saharan countries have adopted cost-reduction policies to facilitate access to health care. However, several studies underline the reimbursement delays experienced by health facilities, which lead to deficient implementation of these policies. In April 2016, for its free care policy, Burkina Faso shifte...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa039

    authors: Meda IB,Kouanda S,Dumont A,Ridde V

    更新日期:2020-08-01 00:00:00

  • Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage.

    abstract::Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have la...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu072

    authors: Asfaw E,Dominis S,Palen JG,Wong W,Bekele A,Kebede A,Johns B

    更新日期:2014-09-01 00:00:00

  • Costing essential services package provided by a non-governmental organization network in Bangladesh.

    abstract::The health profile of Bangladesh has improved remarkably, yet gaps in delivering quality health care remain. In response to the need for evidence to quantify resources for providing health services in Bangladesh, this study estimates unit costs of providing the essential services package (ESP) in the not-for-profit se...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx105

    authors: Zeng W,Halasa YA,Cros M,Akhter H,Nandakumar AK,Shepard DS

    更新日期:2017-12-01 00:00:00

  • Expenditure tracking and review of reproductive maternal, newborn and child health policy in Pakistan.

    abstract::Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx021

    authors: Malik MA,Nahyoun AS,Rizvi A,Bhatti ZA,Bhutta ZA

    更新日期:2017-07-01 00:00:00

  • The complex association of health insurance and maternal health services in the context of a premium exemption for pregnant women: a case study in Northern Ghana.

    abstract:BACKGROUND:Health insurance premium exemptions for pregnant women are a strategy to increase coverage of maternal health services in sub-Saharan countries. We examine health insurance registration among pregnant women before or after the introduction of a premium exemption, and test whether registration increases utili...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czt086

    authors: Frimpong JA,Helleringer S,Awoonor-Williams JK,Aguilar T,Phillips JF,Yeji F

    更新日期:2014-12-01 00:00:00

  • Policymaking 'under the radar': a case study of pesticide regulation to prevent intentional poisoning in Sri Lanka.

    abstract:BACKGROUND:Suicide in Sri Lanka is a major public health problem and in 1995 the country had one of the highest rates of suicide worldwide. Since then reductions in overall suicide rates have been largely attributed to efforts to regulate a range of pesticides. The evolution, context, events and implementation of the k...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czt096

    authors: Pearson M,Zwi AB,Buckley NA,Manuweera G,Fernando R,Dawson AH,McDuie-Ra D

    更新日期:2015-02-01 00:00:00

  • Delivery-related complications and determinants of caesarean section rates in India.

    abstract::Caesarean section rates have been increasing worldwide, raising the question of the appropriateness of the selection of cases for the procedure. This paper examines the levels and correlates of delivery-related complications and caesarean section deliveries in 18 selected states of India in terms of specific maternal ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/17.1.90

    authors: Mishra US,Ramanathan M

    更新日期:2002-03-01 00:00:00

  • Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial.

    abstract:BACKGROUND:One billion children live in war-affected regions of the world. We conducted the first cost-effectiveness analysis of an intervention for war-affected youth in sub-Saharan Africa, as well as a broader cost analysis. METHODS:The Youth Readiness Intervention (YRI) is a behavioural treatment for reducing funct...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czv078

    authors: McBain RK,Salhi C,Hann K,Salomon JA,Kim JJ,Betancourt TS

    更新日期:2016-05-01 00:00:00

  • Public and private hospitals in Bangladesh: service quality and predictors of hospital choice.

    abstract::This study compares the quality of services provided by public and private hospitals in Bangladesh. The premise of the paper was that the quality of hospital services would be contingent on the incentive structure under which these institutions operate. Since private hospitals are not subsidized and depend on income f...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/15.1.95

    authors: Andaleeb SS

    更新日期:2000-03-01 00:00:00

  • Determinants of patient choice of medical provider: a case study in rural China.

    abstract::This study examines the factors that influence patient choice of medical provider in the three-tier health care system in rural China: village health posts, township health centres, and county (and higher level) hospitals. The model is estimated using a multinomial logit approach applied to a sample of 1877 cases of o...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/13.3.311

    authors: Yip WC,Wang H,Liu Y

    更新日期:1998-09-01 00:00:00

  • Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme.

    abstract::Neonatal deaths account for about half of all deaths among children under 5 years of age in Bangladesh, making prevention a major priority. This paper reports on a study of neonatal deaths in 12 areas of Bangladesh served by a large NGO programme, which had high coverage of reproductive health outreach services and re...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czl024

    authors: Mercer A,Haseen F,Huq NL,Uddin N,Hossain Khan M,Larson CP

    更新日期:2006-11-01 00:00:00

  • Lessons learned in using realist evaluation to assess maternal and newborn health programming in rural Bangladesh.

    abstract::Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv053

    authors: Adams A,Sedalia S,McNab S,Sarker M

    更新日期:2016-03-01 00:00:00

  • User fees and drug pricing policies: a study at Harare Central Hospital, Zimbabwe.

    abstract::In 1991, Zimbabwe introduced cost recovery measures as part of its programme of economic reforms, following a course taken by many developing countries. The system of user fees in public health care, aimed to 'protect and support the vulnerable groups' by exemption or incremental fees based on 4 income brackets. Drugs...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/10.3.319

    authors: Chisadza E,Maponga CC,Nazerali H

    更新日期:1995-09-01 00:00:00

  • Health governance and healthcare reforms in China.

    abstract::This article examines the role of health governance in shaping the outcomes of healthcare reforms in China. The analysis shows that the failure of reforms during the 1980s and 1990s was in part due to inadequate attention to key aspects in health governance, such as strategic interactions among government, providers a...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs109

    authors: Ramesh M,Wu X,He AJ

    更新日期:2014-09-01 00:00:00