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Estimated Financing Amount Needed for essential medicines in China, 2014

Chinese Medical Journal 2016年第6期129卷 716-722页

作者： Wei Xu Zheng-Yuan Xu Gong-Jie Cai Chiao-Yun Kuo Jing Li Yi-Syuan Huang School of International Pharmaceutical Business China Pharmaceutical University Nanjing Jiangsu 211198 China International Center for Regulatory Science School of Pharmacy University of Southern'California Los-Angeles cA 90089 USA Titus Family Department of Clinical Pharmacy and Pharmaceutical Economics and Policy School of Pharmacy University of Southern California Los Angeles CA 90089 USA

Background： At the present time, the government is considering to establish the independent financing system for essential medicines （EMs）. However, it is still in the exploration phase. The objectives of this study were to calculate and estimate financing amount of EMs in China in 2014 and to provide data evidence for establishing financing mechanism of EMs. Methods： Two approaches were adopted in this study. First, we used a retrospective research to estimate the cost of EMs in China in 2014. We identified all the 520 drugs listed in the latest national EMs list （2012） and calculated the total sales amount of these drugs in 2014. The other approach included the steps that first selecting the 109 most common diseases in China, then identifying the EMs used to treat them, and finally estimating the total cost of these drugs. Results： The results of the two methods, which showed the estimated financing amounts of EMs in China in 2014, were 17,776.44 million USD and 19,094.09 million USD, respectively. Conclusions： Comparing these two results, we concluded that the annual budget needed to provide for the EMs in China would be about 20 billion USD. Our study also indicated that the irrational drug use continued to plague the health system with intravenous fluids and antibiotics being the typical examples, as observed in other studies.

关键词： China essential medicines Financing Amount Financing Mechanism Irrational Drug Use

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A Cross-sectional Study Assessing Predictors of essential medicines Prescribing Behavior Based on Information-motivation-behavioral Skills Model among County Hospitals in Anhui, China

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Chinese Medical Journal 2015年第21期128卷 2887-2895页

作者： Yun-Wu Zhao Jing-Ya Wu Heng Wang Nian-Nian Li Cheng Bian Shu-Man Xu Peng Li Hua Lu Lei Xu Department of Health Services Management Schoo of Health Administration Anhui Medical University Hefei Anhui 230032 China Department of Research Administration Office Fourth Affiliated Hospital of Anhui Medical University Hefei Anhui 230000 China Department of Dean's Office (HW) Department of Research Administration Office (NNL) Department of Medical Affaires (PL) First Affiliated Hospital of Anhu Medical University Hefei Anhui 230022 China Department of Medical Affaires Guangdong Women and Children Hospital Guangzhou Guangdong 510010 China Department of Personnel Anhui Provincial Hospital Hefei Anhui 230001 China Department of Foreign Languages School of Humanities Tianjin University of Finance and Economics Tianjin 300222 China

Background： The self-consciousness and practicality of preferentially prescribed essential medicines （EMs） are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills （IM B） model to identify the predictors of essential medicines prescribing behavior （EMPB） among doctors and to examine the association between demographic variables, IMB, and EMPB. Methods： A cross-sectional study was carried out to assess predictive relationships among demographic variables and IM B model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province. A structural equation model was constructed for the I MB model to test the instruments using analysis of moment structures 17.0. Results： A total of 732 participants completed the survey. The average age of the participants was 37.7 ± 8.9 years old （range： 22-67 years old）. The correct rate of information was 90.64%. The average scores of the motivation and behavioral skills were 45.46 a： 7.34 （hundred mark system： 75.77） and 19.92 ± 3.44 （hundred mark system： 79.68）, respectively. Approximately half（50.8%） of respondents reported that the proportion of EM prescription was below 60%. The final revised model indicated a good fit to the data （x^2/df= 4.146, goodness of fit index = 0.948, comparative fit index = 0.938, root mean square error of approximation = 0.066）. More work experience （β = 0.153, P 〈 0.001 ） and behavioral skills （β = 0.449, P 〈 0.001 ） predicted more EMPB. Higher income predicted less information （β = -0.197, P 〈 0.001） and motivation （β =0.204, P 〈 0.001 ）. Behavioral skills were positively predicted by information （β = 0.135, P 〈 0.001 ） and motivation （β = 0.742, P 〈 0.001 ）. Conclusion： The present study predicted some factors of EMPB, and specified the relationships among the model variables. The utilization rate of EM was not high enough. Motivation and behavior skills were crucial factors affecting EMPB. The inf

关键词： China County Hospitals essential medicines Information-motivation-behavioral Skills Model PrescribingBehavior Structural Equation Model

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