Abstract
BackgroundTo explore the key factors affecting prescription practices of essential medicines in Chinese county hospital. National essential medicine policy (NEMP) plays important roles in health care system, especially in developing countries. As a fundamental component in the Chinese health system reform, NEMP was implemented in primary health care institutions during the first stage of reform. As it is rolled out, priority usage and zero-mark-up policy of essential medicines are to be applied in every government-run healthcare institution. However, the intention and influence factors of physicians on priority selecting essential medicine remains unclear.MethodsBased on the theory of planned behavior, a cross-sectional questionnaire survey was conducted to analyze physicians’ intention, attitude, subjective norms (SNs) and perceived behavioral control (PBC) on prescrictions and their actual behavior on selection of essential medicines.ResultsTwo hundred eighty-two physicians participated in the structural questionnaire interview. The final structural equation model reflected influencing factors affecting physicians’ prescribing behavior (χ2/df = 1.32, GFI = 0.99, IFI = 0.99). Structural equation model analysis showed that attitude, other influencers and institutional environment, and PBC significantly affected behavioral intention. However, the control extent of cognition behavior of physicians prescribing had no significant positive effect on the priority usage of essential medicines.ConclusionInvestigation results demonstrate physicians are unaware of NEMP design and implementation plans. To help enhance rational use of essential medicines we suggest educating physicians on the value of NEMP, and integrating the drug shortage report into the essential medicine (EM) bidding system seamless communication with pharmaceutical manufacturers’ credit information system.
Highlights
To explore the key factors affecting prescription practices of essential medicines in Chinese county hospital
Have there been any significant changes of the physicians’ prescription behaviors in selecting essential medicine in county hospitals? If so, has this change met the expectations of policy design? These are all issues that should be of concern
According to recommendations by Hoyle and Panter [16], we reported multiple indexes of fit including chi-square, goodness-of-fit index (GFI), incremental-fit index (IFI), comparative-fit index (CFI), and root mean square error of approximation (RMSEA)
Summary
To explore the key factors affecting prescription practices of essential medicines in Chinese county hospital. As a fundamental component in the Chinese health system reform, NEMP was implemented in primary health care institutions during the first stage of reform. As it is rolled out, priority usage and zero-markup policy of essential medicines are to be applied in every government-run healthcare institution. County public hospitals are the main medical institutions that provide health service for urban and rural populations. They have become important links from the reform of primary medical institutions to the overall implementation in China. Have there been any significant changes of the physicians’ prescription behaviors in selecting essential medicine in county hospitals? If so, has this change met the expectations of policy design? These are all issues that should be of concern
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