Effects of China's National Essential Medicines Policy on the Use of Injection in Primary Health Facilities

The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the effect of national essential medicines policy(NEMP) on injection use at primary health facilities in China by investigating their prescription information.Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011.The injection use was measured as the indicator as the percentage of prescriptions with one or more injections.The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82%(2 =11.158,P=0.001) in the all survey areas during the NEMP reform.The difference in level of the injection use in 2011 was significant among the eastern,central and western regions(2 =223.584,P=0.000);level of the injection use in western region was the lowest(27.73%),while that in the central region was the highest(43.10%).The level of the injection use in 2011 among different provinces was also of great difference(26.00%-58.25%,range:32.25%).The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries(13.4%-24.1%).It was concluded that NEMP has improved injection use in China,but the injection abuse situation remains serious,indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs,especially the injection use.

Modelling geographic accessibility to Primary Health Care Facilities:combining open data and geospatial analysis

Ensuring healthy lives and promoting well-being for all ages is the 3rd Sustainable Development Goal(SDG).Inequality in access to health care remains one of the primary challenges in achieving the goal.With the ever-increasing expansion of urban areas and population growth,there is a need to regularly examine the pattern of accessibility of basic amenities across regions,States and urban areas.This study examined geographic access to Primary Health Care Facilities(PHCF)in Nigeria using the combination of open data and geospatial analysis techniques.Thus,showcasing an approach can be replicated across different regions in Sub-Saharan Africa due to issues of information gap.Data on elevation,location of health care facilities,population and network data were utilised.The result shows that PHCF aggregate at certain locations,e.g.major urban agglomerations,and transit route leading to these places.High concentrations are found in the capital city.The average travel time to the nearest PHCF is about 14 min(Standard Deviation±13.30 min)while the maximum is about 2 hours.Pockets of low accessibility areas exist across the Akwa Ibom State in the Niger Delta region of Nigeria.There is an indication that most places have good geographic access.Across the 1787 settlements identified in our dataset,98.3%are with good access(<30 min),27 settlements are located in the poor access class(31–60 min),while two settlements are within the very poor access class(>60 min).Geographic access is not the main limiting factor to health care access in the region.Therefore,computation of access to health care should take into consideration other dimensions of accessibility,to create a robust measure which will support effective and efficient health care planning and delivery.

2019—2021年潍坊市基层卫生服务机构收支水平和结构

目的以山东省潍坊市为例,分析2019—2021年基层卫生服务机构收支水平和结构的变化趋势及不同特征机构的差别,了解突发重大传染病疫情给基层卫生服务机构带来的挑战,为进一步加强基层卫生体系建设提供建议。方法收集潍坊市2019—2021年基层卫生服务机构数据,分析收入总额和结构、支出总额和结构、收支结余的变化趋势,以及不同特征基层卫生服务机构的收支变化差别。结果2019—2021年,潍坊市基层卫生服务机构的总收入保持增长趋势,2019—2020年医疗业务收入增长率相对较低。基层卫生服务机构支出增长率逐年提高,公共卫生支出增长率明显高于医疗支出增长率。3年间,基层卫生服务机构亏损减少并得到扭转。医疗收入受影响最大的是医疗服务能力较低的机构。财政补助收入变化程度最大的是覆盖人口数多、承担公共卫生工作量较多的机构,并且这类机构亏损最严重。结论医疗业务收入增长受疫情冲击最大,此时,财政补助收入的高增长率对维持机构经济平稳运行起到重要作用,但财政补助投入仍需要长效机制的支持。在高公共卫生支出背景下,须关注公共卫生工作量大的基层卫生服务机构的亏损问题。财政投入在发挥兜底功能的同时,应着重用于提高基层卫生服务机构的医疗业务能力。