Evaluación de la introducción e impacto del plan nacional de medicamentos esenciales de China en tres provincias

78Citations
Citations of this article
9Readers
Mendeley users who have this article in their library.
Get full text

Abstract

Objective To evaluate implementation of the National Essential Medicines Scheme (NEMS) in rural China. Methods Two rural counties/districts in each of three provinces where NEMS had been implemented were surveyed. Information was collected from NEMS staff at the province, county/district, township and village levels; patients with chronic disease were also interviewed. Service provision, finances, prescriptions, inpatient records and the expenditures of patients with certain diagnoses were investigated in township hospitals and village clinics. The results were compared with the corresponding data recorded before NEMS was introduced. Findings Following the introduction of NEMS, drug procurement in each study location was systematized. Total drug costs declined. This, and improved prescribing, reduced the costs of outpatient and inpatient care and led, apparently, to increased uptake of health services. However, the prices of some drugs had increased and the availability of others had declined. The compensation of health-care providers for NEMS-related reductions in their incomes had been largely ineffective. As a result of the introduction of NEMS, health facilities relied more on public financing. Many health-care providers complained about higher workloads and lower incomes. Conclusion Although it was well conceived, the introduction of NEMS into China's decentralized, fee-for-service system of health care has not been straightforward. It has highlighted the problems associated with attempts to modernize health care and health financing for patients' benefit. Sustainable mechanisms to compensate health-care providers for lost income are needed to ensure that NEMS is a success.

Cite

CITATION STYLE

APA

Li, Y., Ying, C., Sufang, G., Brant, P., Bin, L., & Hipgrave, D. (2013). Evaluación de la introducción e impacto del plan nacional de medicamentos esenciales de China en tres provincias. Bulletin of the World Health Organization, 91(3), 184–194. https://doi.org/10.2471/BLT.11.097998

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free