OBJECTIVE:To provide reference for the further implementation of national essential medicine system of township hospitals. METHODS:5% township hospitals in a province were collected as sample by using random cluster sampling method, and statistics,comparison and evaluation was made by issuing questionnaires to get health resources distribution status,health ser-vice status and income and expenditure status before(in 2009 and 2010)and after(from 2011 to 2013)the implementation of na-tional essential medicine system of township hospitals. RESULTS:Totally 46 township hospitals were surveyed and totally 46 ques-tionnaires of township hospitals were recycled. Average number of beds in township hospitals increased from 15.1 beds in 2009 to 19.4 beds in 2013. Average annual outpatients increased from 11 200 in 2009 to 16 100 in 2013,and average number of hospital discharge increased from 644 in 2009 to 924 in 2013. The proportion of government financing to total income increased from 25.9% in 2009 to 47.1% in 2013,proportion of drug income to the total income decreased from 54.9% to 29.7%,drug profit rate decreased from 25.5% to 3.7%,and proportion of township hospital under deficit decreased from 17.4% to 4.3%. Average time that residents see a doctor in township health center increased from 0.47 in 2009 to 0.74 in 2013,and cost of average hospitaliza-tion and outpatient drugs decreased from 805 to 718 and 28.1 to 24.1,respectively. CONCLUSIONS:The implementation of nation-al essential medicine system has no negative effect on outpatient service,but first inhibits then promotes the inpatient services. Na-tional essential medicine system has effectively cut down the financial burden of drugs,but it has no effect on total health burden. It is difficult to realize the excessive rapid rise of health ex-pense by the single implementation of essential medicine sys-tem,and it needs comprehensive reform,collaboration and in-teraction of medicine and health to effectively relieve the prob-lem of“expensive ill”.

Objective Measure the variation trend and the problems of bed allocation and its equity at primary medical institutions and provide theoretical basis for optimizing the policy of health resources allocation for the government.Methods Analysis of the distribution and equity of the inpatient beds at primary medical institutions in terms of geographical area by means of the survey of regular overall statistics forms and the methods of Gini coefficient and Theil index.Results From 2009 to 2012,the number increase of beds at such institutions geographically was 7.72%,while that in eastern,central and western regions of China were respectively 5.35%, 3.97% and 27.88%.The number increase at community healthcare centers was 46.58%,while that in eastern,central and western regions of the country were respectively 18.09%,29.57%和 81.53%.The number increase at township hospitals was 2.33%,while that in eastern,central and western regions were respectively - 3.83%,- 0.43% and 22%.The Gini coefficient of bed allocation at such institutions was beyond 0.6,while that in eastern, central and western regions were respectively under 0.3,0.3-0.4 and 0.6 above.The Gini coefficient of bed allocation at community healthcare centers fell from above 0.4 to under 0.4.The Gini coefficient in the western regions increased from 0.3-0.4 to over 0.4.The variation trend of township hospitals was similar with the overall conditions at such institutions.The intra-regional Theil indexes and their contribution rates of bed allocation at such institutions were higher than those of inter-regional. Conclusions The overall variation trend of bed allocation at such institutions was on the rise,yet its variation trend of equity remains unchanged.The bed allocation and its equity at such institutions were higher than those at township hospitals.The growth rate in western regions was the highest,but the absolute number was the lowest.Moreover,the equity of bed allocation in such regions was not only the lowest,but also was found rising.The influence of bed allocation in intra-region terms was large,while its equity was not only lower but falling as well.

OBJECTIVE:To provide basis for the further implementation of the national essential medicine system in township hospitals. METHODS:By issuing questionnaires,an investigation was made on the basic information of township hospitals imple-menting“Health Ⅺ project”in Heilongjiang Province before and after the implementation of the national essential medicine system. Prescriptions of 4 days in 2008 and 2012 were extracted,statistically compared and analyzed by using random system cluster sam-pling medication rationality was evaluated. RESULTS:40 questionnaires and 3 173 prescriptions were recycled during the investiga-tion in 2009,and 40 questionnaires and 4 197 prescriptions were recycled in 2013. Compared with the township hospitals in project areas in 2008,the proportion of practice(assistant)physicians per township hospitals and the average number of beds were respec-tively increased by 1.5%and 4.6 in 2012. The average kind of prescription drugs was decreased from 2.9 kinds to 1.7 kinds,the us-age rate of infusion was decreased from 46.5%to 30.6%,antibiotics was decreased from 61.5%to 40.0%,two or more kinds anti-biotics was decreased from 18.9% to 4.8%,hormone was decreased from 11.9% to 4.2% and the rate of combined use of antibiot-ic and hormone was decreased from 9.2% to 2.8%;the drug expenditure of each outpatient service and hospitalization was respec-tively decreased 19.1% and 16.4%. There were significant differences(P<0.05). CONCLUSIONS:After the implementation of na-tional essential medicine system,the medication rationality of township hospitals in project areas has made great improvement,es-pecially on the aspects of prescription drug number,the combined usage rate of antibiotic and hormone,the usage of hormone and the drug expense burden,which reaches the policy targets;although the infusion rate and the usage of antibiotic show great im-provements,there are still some gaps between the current situation and the policy targets;the obvious decrease of the average drug expenditure of each service doesn’t make a relative decrease of the average expenditure of each medical service,which has a little increase.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.

Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.