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. 2017 Nov 13;17(1):723.
doi: 10.1186/s12913-017-2698-x.

The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China

Zhigang Guo  1 , Xiaodong Guan  2   3 , Luwen Shi  1   4
Affiliations

The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China

Zhigang Guo et al. BMC Health Serv Res. .

Abstract

Background: In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China.

Methods: The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented).

Results: The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p < 0.01), while the ratio of financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p < 0.01). The rate of healthcare workers income growth was greater in the treatment group (15.35% VS 5.79%, p = 0.006). The treatment group exhibited higher outpatient and emergency visits per month in urban areas (2720 VS 1763 visits per month) and rural areas (3830 VS 3633), and higher prescriptions per month in urban areas (2048 VS 1025, p = 0.005) and rural areas (3806 VS 3251). The treatment group used more essential medicines and received greater income from essential medicines while the drug price markup rate was lower.

Conclusions: The NEMPs appear to affect the transformation of the operation mechanisms of primary healthcare institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

Keywords: Drug price markup rate; Essential medicines; Health care reform; Primary healthcare institutions.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval is not required for conducting this type of survey in China, because our study and team members have no direct contact with human subjects (reference file # Science and Education Department of Ministry of Health [2007] 17#.

http://www.moh.gov.cn/mohbgt/pw10702/200804/18816.shtml). All of the information from institutions or study-related persons was anonymized and de-identified prior to analysis.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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