The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of...The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.展开更多
Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious diseases.This study explored the impact of the NMR on the accessibility ...Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious diseases.This study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies(mAbs),and the effective promotion policies after the NMR.Methods We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province,China.By interviewing hospital pharmacy experts,we identified the potential value of the current NMR in improving the access to therapeutic mAbs.Results The average availability of 13 mAbs increased by 8.1%in the surveyed hospitals of Hubei province after the NMR.The median unit price of 10 mAbs dropped by 34.3%.The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident(56.2%reduction).The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of mAbs.However,the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of mAbs.Conclusion Not all current NMR policies play a positive role in promoting the accessibility of mAbs.To further improve the accessibility of mAbs in the future in China,it is therefore critical to increase the investment in independent research and development of high-quality mAbs,establish localized guidelines for the rational use of mAbs in clinical practice,and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.展开更多
The national economy development and the demanding of the drugs request the pharmaceutical industry in China to keep sustainable development especially under the background of the new medical reform. According to the ...The national economy development and the demanding of the drugs request the pharmaceutical industry in China to keep sustainable development especially under the background of the new medical reform. According to the status of industry development and drug consumption in China, the trend and the driving factors for pharmaceutical industry in the future were estimated. Based on the analysis of the background and conditions for pharmaceutical industry sustainable development in China, the problems and challenges, the goal as well as the main measures for the sustainable development of pharmaceutical industry were put forward.展开更多
Our country rural area has carried out broad practice on new model system of rural cooperative medical services, and the rural new medical treatment system has developed quickly. However, there are still many problems...Our country rural area has carried out broad practice on new model system of rural cooperative medical services, and the rural new medical treatment system has developed quickly. However, there are still many problems which needs us to solve. This article will analysis its present situation, problems and reasons, then give some suggestions to solve these problems. The new rural cooperative medical system has made great achievements since its implementation, which is a radical reform of the traditional medical systen. Lcd by thc govcmmcnt, trying to solve the majority of the Chinese population of the peasant groups to see the doctor difficult and expensive medical problems, and effectively protect the vital interests of farmers, so that people=oriented, establish and improve the rural medical service system. This paper analyzes the status quo of the new rural cooperative medical system, puts forward the problems, finds the reasons, and puts forward the corresponding countermeasures on the basis of this.展开更多
This study investigates the impact of the New Rural Cooperative Medical Scheme(NRCMS)on rural households to escape poverty.We employ the instrumental variable method,the IVProbit model,to analyze the national data fro...This study investigates the impact of the New Rural Cooperative Medical Scheme(NRCMS)on rural households to escape poverty.We employ the instrumental variable method,the IVProbit model,to analyze the national data from the rural-resident field survey by the China Family Panel Studies(CFPS)in 2016.Based on the large-scale data,we found that,first,the hospitalization of family members is the key factor in increasing the risk of the family falling into poverty.The NRCMS has significantly reduced the likely risk of falling into poverty.Second,the impact of the NRCMS on poverty alleviation varies among groups with different levels of income.There is no impact on the upper-middle and high-income groups;in contrast,the NRCMS has substantially improved the capacity of low-income rural families to prevent poverty due to illness,especially for the lower-middle-income group.Third,there exist significant regional differences in the impact of NRCMS on the health poverty alleviation of rural households in China.The NRCMS has successfully reduced the risk of rural households in the western region falling into poverty,simultaneously,no significant impact on those in the eastern and central regions.In order to diminish and eliminate poverty eventually and boost rural residents'capacity for income acquisition,we propose the following:raise the actual compensation ratio of the NRCMS,control the rising expense of NRCMS by promoting the payment method reform,construct the comprehensive healthcare system in the western region,strengthen the medical security for the poor in remote area,and enhance the living environment for rural residents.展开更多
China's Rural Cooperative Medical System collapsed alongside communal farming at the end of the Maoist period in 1976, leaving most farmers vulnerable[1]. In rural areas, where 80% of people have been without health ...China's Rural Cooperative Medical System collapsed alongside communal farming at the end of the Maoist period in 1976, leaving most farmers vulnerable[1]. In rural areas, where 80% of people have been without health insurance of any kind, illness has emerged as a leading cause of poverty[24]. To address the poor state of health care among the rural population, in 2003 the Chinese government launched the New Rural Cooperative Medical System (NCMS),展开更多
Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods (random-effect probit regression model and DID methods), this study conducted an empirical analysis to estimate the impact of NCMS...Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods (random-effect probit regression model and DID methods), this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization (outpatient and inpatient) of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization (both outpatient and inpatient) between the NCMS enrollment group and the non-enrollment group in both working age group (15-59) and the elderly group (60 and over). Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior (visiting the hospital to receive a health examination) in the working age group, but the effect did not appear in the elderly group.展开更多
In 2003, China initiated the New Rural Cooperative Medical Scheme (NRCMS) in order to provide basic health care coverage for the rural population. However, the NRCMS has had a marked impact on rural-urban labor mig...In 2003, China initiated the New Rural Cooperative Medical Scheme (NRCMS) in order to provide basic health care coverage for the rural population. However, the NRCMS has had a marked impact on rural-urban labor migration as its current regulations present a barrier for cross-region participation in the NRCMS, and its reimbursement system is biased when the enrollees seek medical services outside their location of hukou, a household registration system in China. This paper performs a variety of empirical tests on a panel data set from the China Health and Nutrition Survey (CHNS) to study how the NRCMS affects rural residents' work location choices. We observed a "locking effect" on potential rural migrant workers and a "pulling effect" on existing ones. According to the results, the NRCMS has discouraged rural residents from working outside their location of hukou, lowering the probability of relocation by 3.52 percent. Meanwhile, the NRCMS system actually encourages existing migrant workers to return home. This paper concludes that the NRCMS has to some extent restrained the free flow of the labor force and exacerbated the migrant worker shortage.展开更多
Background: The New Rural Cooperative Medical Scheme (NCMS) has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we ai...Background: The New Rural Cooperative Medical Scheme (NCMS) has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years. Methods: The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS. Results: In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund ofNCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively. Conclusions: With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers' medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.展开更多
Background:Tuberculosis(TB)is still a major public health problem in China.To scale up TB control,an innovative programme entitled the'China-Gates Foundation Collaboration on TB Control in China was initiated in 2...Background:Tuberculosis(TB)is still a major public health problem in China.To scale up TB control,an innovative programme entitled the'China-Gates Foundation Collaboration on TB Control in China was initiated in 2009.During the second phase of the project,a policy of increased reimbursement rates under the New Cooperative Medical Scheme(NCMS)was implemented.In this paper,we aim to explore how this reform affects the financial burden on TB patients through comparison with baseline data.Methods:In two cross-sectional surveys,quantitative data were collected before(January 2010 to December 2012)and after(April 2014 to June 2015)the intervention in the existing NCMS routine data system.Information on all 313 TB inpatients,among which 117 inpatients in the project was collected.Qualitative data collection included 11 focus group discussions.Three main indicators,non-reimbursable expenses rate(NER),effective reimbursement rate(ERR),and out-of-pocket payment(OOP)as a percentage of per capita household income,were used to measure the impact of intervention by comprising post-intervention data with baseline data.The quantitative data were analysed by descriptive analysis and non-parametric tests(Mann-Whitney U test)using SPSS 22.0,and qualitative data were subjected to thematic framework analysis using NvivolO.Results:The nominal reimbursement rates for inpatient care were no less than 80%for services within the package.Total inpatient expenses greatly increased,with an average growth rate of 11.3%.For all TB inpatients,the ERR for inpatient care increased from 52 to 66%.Compared with inpatients outside the project,for inpatients covered by the new policy,the ERR was higher(78%),and OOP showed a sharper decline.In addition,their financial burden decreased significantly.Conclusions:Although the nominal reimbursement rates for inpatient care of TB patients greatly increased under the new reimbursement policy,inpatient OOP expenditure was still a major financial problem for patients.Limited diagnosis and treatment options in county general hospitals and inadequate implementation of the new policy resulted in higher inpatient expenditures and limited reimbursement.Comprehensive control models are needed to effeaively decrease the financial burden on all TB patients.展开更多
Disease has been one of the top reasons accounting for impoverishment in rural China. The government subsidizes health care through the New Cooperative Medical System since 2003 ( NCMS ). The paper studies the effec...Disease has been one of the top reasons accounting for impoverishment in rural China. The government subsidizes health care through the New Cooperative Medical System since 2003 ( NCMS ). The paper studies the effectiveness of various reimbursement arrangements in reducing the financial burden caused by health care in rural China. Using data from China Health and Nutrition Survey(CHNS) , it finds that the severity of illness, the type of illness, medical cost and other costs of the treatment are significantly influencing the choice of a type of treatment. Based on the estimated demand function, the paper concludes that the reimbursement for inmpatient care only has little effect on reducing the financial burden and the incidence of catastrophic expenditure and that expending subsidies to outpatient care is a more effective policy.展开更多
According to the recently released Journal Citation Report(JCR),Chinese Medical Journal’s impact factor(IF)increasedyear by year.The new IF in 2006 is 0.615,increased by 9.6% compared to 2005(0.561),meanwhile the tot...According to the recently released Journal Citation Report(JCR),Chinese Medical Journal’s impact factor(IF)increasedyear by year.The new IF in 2006 is 0.615,increased by 9.6% compared to 2005(0.561),meanwhile the total cite in 2006is 1948,increased by 12.2% compared with 2005(1736).The top cited papers published in our journal from 2004 to2006 are listed as follows.We would like to present our acknowledgements to all the authors and reviewers.展开更多
On the morning of May 22, Dr.Cong Huiquan, international project leader under the French Health Ministry’s Medical Service, led a delegation from Montpellier University Hospital on a visit to Chengdu. During the visi...On the morning of May 22, Dr.Cong Huiquan, international project leader under the French Health Ministry’s Medical Service, led a delegation from Montpellier University Hospital on a visit to Chengdu. During the visit, the cooperation MOU was renewed with the展开更多
This paper suggests a novel approach concerning the medical treatment of human beings, which appears to be economically and practically superior to either biomedicine or traditional medicine. A brand new medical syste...This paper suggests a novel approach concerning the medical treatment of human beings, which appears to be economically and practically superior to either biomedicine or traditional medicine. A brand new medical system--Hehe (和合) medicine, has been proposed based on a preventive-biomedical-psycho-social treatment model. This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life. Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means. Medical services would be firstly provided to the prevention of potential disease germinating in the human body, and clinical medical treatment would be the last resort of systematic medical practice. This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine, especially how both medical systems compare in cognitive style, on a cultural level, and on a technical level.展开更多
基金2022 Education and Teaching Reform Research Project of Xi’an Medical University,“Construction and Practice of Teaching Quality Assurance System in Three-Level Teaching Bases of General Practice Medicine Under the‘Internet+’Model”(Project number:2022JG-05)2021 Shaanxi Undergraduate and Higher Continuing Education Teaching Reform Research Project of Shaanxi Provincial Department of Education,“Construction of Teaching Staff Based on‘Online Learning Platform for Clinical Teachers of the First Affiliated Hospital of Xi’an Medical University’and Construction and Practice of Quality Assurance System”(Project number:21BZ066)。
文摘The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.
基金supported by the grants from the National Natural Science Foundation of China(No.70903025,No.71373089).
文摘Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious diseases.This study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies(mAbs),and the effective promotion policies after the NMR.Methods We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province,China.By interviewing hospital pharmacy experts,we identified the potential value of the current NMR in improving the access to therapeutic mAbs.Results The average availability of 13 mAbs increased by 8.1%in the surveyed hospitals of Hubei province after the NMR.The median unit price of 10 mAbs dropped by 34.3%.The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident(56.2%reduction).The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of mAbs.However,the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of mAbs.Conclusion Not all current NMR policies play a positive role in promoting the accessibility of mAbs.To further improve the accessibility of mAbs in the future in China,it is therefore critical to increase the investment in independent research and development of high-quality mAbs,establish localized guidelines for the rational use of mAbs in clinical practice,and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.
文摘The national economy development and the demanding of the drugs request the pharmaceutical industry in China to keep sustainable development especially under the background of the new medical reform. According to the status of industry development and drug consumption in China, the trend and the driving factors for pharmaceutical industry in the future were estimated. Based on the analysis of the background and conditions for pharmaceutical industry sustainable development in China, the problems and challenges, the goal as well as the main measures for the sustainable development of pharmaceutical industry were put forward.
文摘Our country rural area has carried out broad practice on new model system of rural cooperative medical services, and the rural new medical treatment system has developed quickly. However, there are still many problems which needs us to solve. This article will analysis its present situation, problems and reasons, then give some suggestions to solve these problems. The new rural cooperative medical system has made great achievements since its implementation, which is a radical reform of the traditional medical systen. Lcd by thc govcmmcnt, trying to solve the majority of the Chinese population of the peasant groups to see the doctor difficult and expensive medical problems, and effectively protect the vital interests of farmers, so that people=oriented, establish and improve the rural medical service system. This paper analyzes the status quo of the new rural cooperative medical system, puts forward the problems, finds the reasons, and puts forward the corresponding countermeasures on the basis of this.
基金supports by the National Social Science Fund of China(18FGL014)the Key Project of Humanities and Social Science Base of Anhui Province of China(SK2019A0491)+4 种基金the Humanities and Social Science Foundation of the Ministry of Education of China(18YJA790065)the Social Science Foundation of Anhui Province of China(AHSKY2017D01)the Outstanding Scholar Project of Anhui Province of China(gxbj ZD12)the Key Project of the Social Science Foundation of Anhui Province of China(AHSKY2020D44)the 2019 Major Project of the Social Science Foundation of Anhui Province of China(AHSKZD2019D04)。
文摘This study investigates the impact of the New Rural Cooperative Medical Scheme(NRCMS)on rural households to escape poverty.We employ the instrumental variable method,the IVProbit model,to analyze the national data from the rural-resident field survey by the China Family Panel Studies(CFPS)in 2016.Based on the large-scale data,we found that,first,the hospitalization of family members is the key factor in increasing the risk of the family falling into poverty.The NRCMS has significantly reduced the likely risk of falling into poverty.Second,the impact of the NRCMS on poverty alleviation varies among groups with different levels of income.There is no impact on the upper-middle and high-income groups;in contrast,the NRCMS has substantially improved the capacity of low-income rural families to prevent poverty due to illness,especially for the lower-middle-income group.Third,there exist significant regional differences in the impact of NRCMS on the health poverty alleviation of rural households in China.The NRCMS has successfully reduced the risk of rural households in the western region falling into poverty,simultaneously,no significant impact on those in the eastern and central regions.In order to diminish and eliminate poverty eventually and boost rural residents'capacity for income acquisition,we propose the following:raise the actual compensation ratio of the NRCMS,control the rising expense of NRCMS by promoting the payment method reform,construct the comprehensive healthcare system in the western region,strengthen the medical security for the poor in remote area,and enhance the living environment for rural residents.
文摘China's Rural Cooperative Medical System collapsed alongside communal farming at the end of the Maoist period in 1976, leaving most farmers vulnerable[1]. In rural areas, where 80% of people have been without health insurance of any kind, illness has emerged as a leading cause of poverty[24]. To address the poor state of health care among the rural population, in 2003 the Chinese government launched the New Rural Cooperative Medical System (NCMS),
文摘Using the 2000, 2004, and 2006 CHNS longitudinal survey data and econometric methods (random-effect probit regression model and DID methods), this study conducted an empirical analysis to estimate the impact of NCMS. The major conclusions are as follows. First, predisposing factors, enabling factors, health care need factors, and lifestyle factors affect health care utilization. Second, results using DID methods indicate that NCMS did not affect health care service utilization (outpatient and inpatient) of individuals when ill, but it might increase the possibility of getting a health examination. Third, there is no difference in health care service utilization (both outpatient and inpatient) between the NCMS enrollment group and the non-enrollment group in both working age group (15-59) and the elderly group (60 and over). Therefore, it can be said that NCMS did not affect the health care utilization in both the group. However, NCMS positively affects disease prevention behavior (visiting the hospital to receive a health examination) in the working age group, but the effect did not appear in the elderly group.
基金This paper is sponsored by the MOE Young Scholars Fund Project of Humanities and Social Sciences, New Rural Cooperative Medical Scheme and its Implication for Work Location Choices of Migrant Workers: A Comparison Study between the New Rural Cooperative Medical Scheme (NRCMS) and the Urban Resident Basic Medical Insurance (grant 20Y.1C790206), and Distinguished Young Scholars Fund Project of the National Natural Science Foundation of China,Intergenerational Transfer Mechanism of Human Capital and its Impact on Social Mobility in China: A Theoretical and Empirical Study" (grant 71103009).
文摘In 2003, China initiated the New Rural Cooperative Medical Scheme (NRCMS) in order to provide basic health care coverage for the rural population. However, the NRCMS has had a marked impact on rural-urban labor migration as its current regulations present a barrier for cross-region participation in the NRCMS, and its reimbursement system is biased when the enrollees seek medical services outside their location of hukou, a household registration system in China. This paper performs a variety of empirical tests on a panel data set from the China Health and Nutrition Survey (CHNS) to study how the NRCMS affects rural residents' work location choices. We observed a "locking effect" on potential rural migrant workers and a "pulling effect" on existing ones. According to the results, the NRCMS has discouraged rural residents from working outside their location of hukou, lowering the probability of relocation by 3.52 percent. Meanwhile, the NRCMS system actually encourages existing migrant workers to return home. This paper concludes that the NRCMS has to some extent restrained the free flow of the labor force and exacerbated the migrant worker shortage.
文摘Background: The New Rural Cooperative Medical Scheme (NCMS) has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years. Methods: The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS. Results: In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund ofNCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively. Conclusions: With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers' medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.
文摘Background:Tuberculosis(TB)is still a major public health problem in China.To scale up TB control,an innovative programme entitled the'China-Gates Foundation Collaboration on TB Control in China was initiated in 2009.During the second phase of the project,a policy of increased reimbursement rates under the New Cooperative Medical Scheme(NCMS)was implemented.In this paper,we aim to explore how this reform affects the financial burden on TB patients through comparison with baseline data.Methods:In two cross-sectional surveys,quantitative data were collected before(January 2010 to December 2012)and after(April 2014 to June 2015)the intervention in the existing NCMS routine data system.Information on all 313 TB inpatients,among which 117 inpatients in the project was collected.Qualitative data collection included 11 focus group discussions.Three main indicators,non-reimbursable expenses rate(NER),effective reimbursement rate(ERR),and out-of-pocket payment(OOP)as a percentage of per capita household income,were used to measure the impact of intervention by comprising post-intervention data with baseline data.The quantitative data were analysed by descriptive analysis and non-parametric tests(Mann-Whitney U test)using SPSS 22.0,and qualitative data were subjected to thematic framework analysis using NvivolO.Results:The nominal reimbursement rates for inpatient care were no less than 80%for services within the package.Total inpatient expenses greatly increased,with an average growth rate of 11.3%.For all TB inpatients,the ERR for inpatient care increased from 52 to 66%.Compared with inpatients outside the project,for inpatients covered by the new policy,the ERR was higher(78%),and OOP showed a sharper decline.In addition,their financial burden decreased significantly.Conclusions:Although the nominal reimbursement rates for inpatient care of TB patients greatly increased under the new reimbursement policy,inpatient OOP expenditure was still a major financial problem for patients.Limited diagnosis and treatment options in county general hospitals and inadequate implementation of the new policy resulted in higher inpatient expenditures and limited reimbursement.Comprehensive control models are needed to effeaively decrease the financial burden on all TB patients.
基金The author is grateful for financial support from the National Science Foundation of China (70573024).
文摘Disease has been one of the top reasons accounting for impoverishment in rural China. The government subsidizes health care through the New Cooperative Medical System since 2003 ( NCMS ). The paper studies the effectiveness of various reimbursement arrangements in reducing the financial burden caused by health care in rural China. Using data from China Health and Nutrition Survey(CHNS) , it finds that the severity of illness, the type of illness, medical cost and other costs of the treatment are significantly influencing the choice of a type of treatment. Based on the estimated demand function, the paper concludes that the reimbursement for inmpatient care only has little effect on reducing the financial burden and the incidence of catastrophic expenditure and that expending subsidies to outpatient care is a more effective policy.
文摘According to the recently released Journal Citation Report(JCR),Chinese Medical Journal’s impact factor(IF)increasedyear by year.The new IF in 2006 is 0.615,increased by 9.6% compared to 2005(0.561),meanwhile the total cite in 2006is 1948,increased by 12.2% compared with 2005(1736).The top cited papers published in our journal from 2004 to2006 are listed as follows.We would like to present our acknowledgements to all the authors and reviewers.
文摘On the morning of May 22, Dr.Cong Huiquan, international project leader under the French Health Ministry’s Medical Service, led a delegation from Montpellier University Hospital on a visit to Chengdu. During the visit, the cooperation MOU was renewed with the
基金Supported by the Soft Scientific Project of Henan Province (No. 102400440059) and the Philosophy and Social Science Program of Henan Province (No. 2011FYY014)
文摘This paper suggests a novel approach concerning the medical treatment of human beings, which appears to be economically and practically superior to either biomedicine or traditional medicine. A brand new medical system--Hehe (和合) medicine, has been proposed based on a preventive-biomedical-psycho-social treatment model. This is characterized by a dual approach in which life nurturing is consistently practised and medical treatment is applied when necessary in order to maintain a healthy life. Its core value would facilitate the self-restoration to health and self-adaptation to nature through health cultivation and medical means. Medical services would be firstly provided to the prevention of potential disease germinating in the human body, and clinical medical treatment would be the last resort of systematic medical practice. This paper discusses not only this new concept but also the advantages of traditional Chinese medicine and biomedicine, especially how both medical systems compare in cognitive style, on a cultural level, and on a technical level.