Objective To analyze the policy effect of first contact care options of residents under the essential medicine system.Methods The samples were divided into a treatment group and a control group depending whether the policy is implemented.Difference-in-differences model was used to estimate the changes in the First Contact Care choice of residents before and after the implementation.Results The net effect of policy is 6.15％,in which the resident category of the household head and per capita income were statistically significant.Conclusion Though the system promotes the first contact of residents for primary institutions,top-level design of the system calls for optimization,efficiency and equity of the health resource allocation of urban and rural health need to be improved,and the division of responsibilities of the two-level medical institutions needs to be clarified in first contact care system.

Introduced are the concept and connotation of the prospect theory in behavioral economics,and the theory is used to explore the psychological characteristics and irrational decision behaviors of both supply and demand sides of talents in human resource development of township hospitals.The study found that the limited rational decision of people influenced the policy effectiveness of human resource policy for such hospitals,and the certainty effect strengthened the demand for restoration of government accountability and the breaking of staffing quota limits.The change and difference of reference point resulted in the lack of incentives and turnover of posts in such hospitals.The presence and change of the mental account caused unscientific human resource development.Based on such findings,the prospect theory can provide good explanatory power and theoretical enlightenment for such development.

Objective:To evaluate communication ability of medical students and try to construct communica-tion education mode of medical students .Methods:Scale and questionnaire are used to survey 1389 medical students , a radar map is used to evaluate the communication and interviewing related personnal , domestic and over-seas pertinent literature data were browsed and analyzed .Results:Medical students′communication ability level is general , lack of communication of knowledge; The need to build on the basis of doctor -patient communication training mode diversification .Conclusions:Medical schools should attach importance to training the students′com-munication ability and try to construct all -sided education mode and improve medical students′ability of doctor-patient communication .

Objective To study and identify factors and evaluation criteria for optional health policy instruments for policy making reference.Methods A field survey was made to the10,000 primary care doctors to rural households campaign in Jining city,covering 453 doctors sent to villages,294 village doctors,and 572 rural residents,with the data obtained subject to descriptive analysis.Results In terms of equity of the campaign,97.8％ of the rural residents have entered into agreements,and 1.715 million of free visits have been provided by family doctors; in terms of economics,most of the superior doctors,rural doctors and rural residents believed that the policy could encourage high quality resources to sink to rural areas,and enhance the competence of public health services by rural doctors.In terms of the adaptability,60.4 ％ of the superior doctors and 92.7％ of the rural doctors hold that they are competent for health care role,but 51.8％ of the superior doctors were found not used to the current working mode.In terms of the enforceability,main complaints of superior doctors and rural doctors were excessive workload,overlong working hours,insufficient medical equipments,and reduced institutional revenue In terms of acceptability,90.4％ of the rural residents are supportive Conclusion The promotion of such a policy calls for a combination of compulsory,voluntary and mixed policy instruments in sinking the resources,with appropriate selection and optimization of such instruments,to ensure outcomes of the policy.

Objective Overall evaluation of the outcomes of the 10,000 primary care doctors to rural households campaign in Jining city,to provide a reference for further implementation of the policy.Methods Multi-stage stratified random sampling method was used for field questionnaires and interviews of rural residents,village doctors and medical workers sent from cities engaged in the campaign.Results The 90.0％ of the rural residents under contract feel satisfied with the level,items,attitude and activeness of the service provided by doctors from cities; 98.3％ of the village doctors said they have been trained by medical workers from cities; 87.0％ and 68.4％ of the village doctors and such medical workers hold that this campaign helps with sinking high quality health resources into rural areas.Conclusion The campaign and policy are conducive to upgrading health service in rural areas,which can be proliferated with further optimization.

Horn-Meter model was used to analyze the problems and obstacles in the10,000 primary care doctors to rural households campaign in Jining city,in terms of policy objectives sand standards,policy resources,institutional characteristics,execution mode,policy implementation environment,and preferences of those who carry out the policy.Based on the energy level and person-post matching,a policy sustainable development model was built and demonstrated,for policy recommendations of optimization and promotion.

Workers with high quality, high job satisfaction levels and high stability are indispensable to the sustainable development of community health services. The present research aimed to find out about the scope of job satisfaction and stability of community health workers by means of designing relevant questionnaires and sample survey and to identify the major factors affecting the scope of job satisfaction and stability. The research found that among the community health workers, those engaged in preventive healthcare were a group with the lowest job satisfaction level and there were six factors affecting the scope of job satisfaction, including working conditions, the effect of the implementation of rules and regulations, respect from and care by leaders and so on. It also found that 45.1% of the workers once had the thought of leaving their community health centers or stations and there were 5 factors affecting job stability, including environment for medical practice, doctor-patient relationship, scope for bringing one's ability into play and so forth.

Objective:To investigate the public attitudes towards violence incidents from the perspective of in-ternet users, by the means of collecting the hospital violence incidents on the internet. Methods:Selected 7 cases of typical hospital violence and divided those comments into three categories, namely,support the medical side,support the patient side and other. The proportions of all kinds of attitudes were analyzed. Summarize the in-centives of hospital violence and analyze the attitudes of internet users from the perspective of social psychology. Results:Internet users had different attitudes to these 7 cases of hospital violence incidents. The proportion of support the medical side was from 0 . 66% to 95 . 82%, and the proportion ofsupport the patient side was from 0. 18% to 81. 25%. This was mainly due to the in-group favoritism, stereotypes, moral judgment and emotional tendencies of internet public opinion and media-induced and other factors. In internet users' view, the low profes-sional ethical quality is considered the most important incentives, and the proportion was 43. 05%. Conclusions:The tendency of the media coverage has an important influence on the attitude of internet users. Policy makers should correctly treat with the two sides of network public opinions, the hospitals should improve the ability to re-spond to public opinion, the media should regulate coverage and publicity.

Objective To analyze implementation outcomes and obstacles of “treatment before payment” reform seen by medical institutions' managers,along with an optimal strategy proposed.Methods Quantitative survey and qualitative interviews were called into play,and the data so acquired are subject to evaluation of the radar chart and fishbone diagram analysis to learn the implementation outcomes and obstacles.Results The reform proves workable at hospitals of county and lower levels,achieving win-win for the people,hospitals and government.Obstacles found include poor allocation of designated funds for risk coverage,insufficient circulating funds in advance,poor risk aversion mechanism,and poor preparation for tertiary hospitals.Conclusion It is recommended to promote awareness of the reform,enhance inter-department cooperation,improve hospital information systems,clarify the screening standards of “purposely evasion offenders”,standardize the issuance and use of the NRCMS certificates,and better build the credit system of the society.

Objective A systematic review of implementation outcomes of the essential medicine system in China to identify scientific evidences for a better system.Methods A systematic review is made to extract data from the research papers on outcomes of the essential medicine system,followed by an analysis and description of such data.Results Of the 87 papers included,most of them focused on primary care institutions,while four of them on residents or patients,and one of them on pharmaceutical enterprises.The study found the medical institutions with rising availability of essential drugs,lowered medicine costs,rising or dropping business volume,and apparent drop of out-of-pocket expenses for patients.These have encouraged rational drug use.Evidences in hand indicate expected outcomes from the essential medicine system.Conclusion Current researches on the system focus on primary care institutions in developed areas in China,lacking rigorous design.Studies of broader scale,further depth and more rigorous designs of the implementations of the system are recommended for evaluation of the impacts and outcomes of the system on various stakeholders of the policy.