Prescribing Patterns in Outpatient Clinics of Township Hospitals in China: A Comparative Study before and after the 2009 Health System Reform

Ding, Ding; Pan, Qingxia; Shan, Linghan; Liu, George; Gao, Lijun; Hao, Yanhua; Song, Jian; Ning, Ning; Li, Ye; Qi, Xiaoying; Liang, Chao; Wu, Qunhong; Liu, Guoxiang

doi:10.3390/ijerph13070679

Cited by 23 publications

(16 citation statements)

References 24 publications

(28 reference statements)

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“…While restricting classes of antibiotics can be effective especially in the short term, it may drive increased use for other drugs which may not be sustainable over the longer term when reductions in usage across the board are required. Essential medicine policies had mixed effects and highlight the need to integrate action on antibiotic use with other health system initiatives. Ding et al [87] and Wei et al [88] addressed the effects of China’s essential medicines policy on levels of antibiotic use in hospitals while Song et al [89] and Yao et al [90] studied its effects in primary care settings. Essential medicine policies are multifaceted involving: establishing a list of essential drugs, supply chain measures and price control.…”

Section: Table A1mentioning

confidence: 99%

Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

2018

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This review identifies evidence on supply-side interventions to change the practices of antibiotic prescribers and gatekeepers in low- and middle-income countries (LMICs). A total of 102 studies met the inclusion criteria, of which 70 studies evaluated interventions and 32 provided insight into prescribing contexts. All intervention studies were from human healthcare settings, none were from animal health. Only one context study examined antibiotic use in animal health. The evidence base is uneven, with the strongest evidence on knowledge and stewardship interventions. The review found that multiplex interventions that combine different strategies to influence behaviour tend to have a higher success rate than interventions based on single strategies. Evidence on prescribing contexts highlights interacting influences including health system quality, education, perceptions of patient demand, bureaucratic processes, profit, competition, and cultures of care. Most interventions took place within one health setting. Very few studies targeted interventions across different kinds of providers and settings. Interventions in hospitals were the most commonly evaluated. There is much less evidence on private and informal private providers who play a major role in drug distribution in LMICs. There were no interventions involving drug detailers or the pharmaceutical companies despite their prominent role in the contextual studies.

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Section: Table A1mentioning

confidence: 99%

Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

2018

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“…About one-third of products listed in the EML are traditional Chinese medicines. 29 The NEMP promotes safe, cheap and less complicated technologies. This may explain why a lower rating was observed from the health workers from the surgical departments, while a higher rating was given by the health workers from the departments of Chinese medicine, compared with those working in the departments of internal medicine.…”

Section: Discussionmentioning

confidence: 99%

Perceived impacts of the national essential medicines system: a cross-sectional survey of health workers in urban community health services in China

et al. 2017

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ObjectivesThis study aimed to investigate the perceptions of primary care workers about the impacts of the national essential medicines policy (NEMP).SettingA cross-sectional questionnaire survey was undertaken in 42 urban community health centres randomly selected from four provinces in China.Participants791 primary care workers rated the impacts of the NEMP on a 5-point Likert scale.Outcome measuresAn average score for the impacts of the NEMP on four aspects (the practice of health workers, interactions of patients with health workers, operations of health centres and provision of medicines) was calculated, each ranging from 0 to 100. A higher score indicates a more positive rating. Linear regression models were established to determine the sociodemographic characteristics (region, age, gender, profession, training, income) that were associated with the ratings.ResultsThe respondents gave an average rating score of 65.61±11.76, 63.17±13.62, 66.35±13.02 and 67.26±11.60 for the impacts of the NEMP on health workers, patients, health centres and provision of medicines, respectively. Respondents from the central region rated the NEMP higher than those from the eastern and western regions. The pharmacists (β=5.457~7.558, p<0.001) and nurses (β=2.612~3.107, p<0.05) gave a more positive rating on the NEMP than their physician counterparts. A higher income was found to be associated with a decrease in the NEMP ratings. Repetitive training was a predictor of higher ratings.ConclusionsThe NEMP has significant impacts (as perceived by the health workers) on health services delivery in primary care settings. However, the impacts of the NEMP vary by region, professional practice and the income level of health workers. It is important to maintain support from physicians through income subsidies (to compensate for potential loss) and training.

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“…This is evidenced by 11 monographs/textbooks and an impressive 173 peer-reviewed publications produced by the CHP staff about the Chinese health system and health reforms published in both English and the Chinese language. Topics have included patient satisfaction (29)(30)(31), medications policy and practice (32)(33)(34)(35)(36)(37)(38)(39)(40), patient safety and organizational safety culture (41,42), health reform (35,(43)(44)(45)(46)(47)(48)(49)(50), health insurance (50)(51)(52), emergency response (53)(54)(55)(56), and human resource management (3).…”

Section: The China Health Program Outcomesmentioning

confidence: 99%

Sino-Australian University Partnership in Health Management Education

Leggat

Liu

2018

Front. Public Health

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This paper outlines a successful partnership program between La Trobe University in Melbourne Australia, and Harbin Medical University in Harbin, China. These two universities have been collaborating for more than 15 years to provide a comprehensive Master of Health Administration program that adapts the Australian curriculum to meet the rapidly increasing need for qualified health services managers throughout China. This paper describes the mechanisms by which the joint programs were developed and how the two universities work together in partnership to continually improve the program components and outcomes, taking into account the significant differences in context and cultures. Since 2001, La Trobe University has enrolled about 1000 Chinese health services managers, with 721 completing a Master's degree, who are now having increasing influence on the reforms of the Chinese health care system. The partnership has enriched Australian knowledge of Chinese culture and values, as well as the Chinese health system and health policies, as evidenced by the large volume of joint publications. The profession of health management has been substantially strengthened in China, and working together, Chinese and Australian academics have had demonstrated impact on enhancing the reforms of the Chinese public health system. Further studies, with sufficient funds for data collection, are needed to evaluate the long-term impacts of transnational programs on academic and health system development in China.

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Prescribing Patterns in Outpatient Clinics of Township Hospitals in China: A Comparative Study before and after the 2009 Health System Reform

Cited by 23 publications

References 24 publications

Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

Interventions to Reduce Antibiotic Prescribing in LMICs: A Scoping Review of Evidence from Human and Animal Health Systems

Perceived impacts of the national essential medicines system: a cross-sectional survey of health workers in urban community health services in China

Sino-Australian University Partnership in Health Management Education

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