文章基本信息

标题：Evaluation, in three provinces, of the introduction and impact of China’s National Essential Medicines Scheme
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作者：Yang Li ; Cui Ying ; Guo Sufang 等
期刊名称：Bulletin of the World Health Organization
印刷版ISSN：0042-9686
出版年度：2013
卷号：91
期号：3
页码：184-194
DOI：10.2471/BLT.11.097998
出版社：World Health Organisation
摘要：Objective To evaluate implementation of the National Essential Medicines Scheme (NEMS) in rural China.Methods 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.Findings 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.Conclusion 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.