Abstract
BackgroundIn 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.MethodsThe 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).ResultsThe 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.ConclusionsThe 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.
Highlights
In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms
The ratio of drug sales of institution revenues was 42.99% in the treatment group, which is significantly lower than the value in the control group (53.90%, p < 0.01)
The NEMPs may be associated with the transformation of the operation mechanisms of primary healthcare institutions and improving the mechanisms for government investment, which is similar to a previous research [28]
Summary
In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. In March 2009, the Chinese government released the first detailed 3-year implementation plan that was designed to deepen healthcare reform [5]. This reform explicitly set “Preliminarily establishment of a national essential medicines system” as one of the top five priorities in order to increase the accessibility of costeffective medicines and decrease drug costs [6,7,8]. The reimbursement rate of the EMs, including the PSEMs, should be significantly higher than nonessential medicines (non-EMs)
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