Objective: To compare utility values measured by different instruments. Methods: Different instruments were used to measure utility values in 350 patients who were diagnosed as age-related macular degeneration at the same time. The median of utility values measured by different instruments was regarded as relative standard utility value to process comparison, analysis of variance, correlation analysis and curve estimation. Results: Most differences and correlations among utility values measured by different instruments were significant, as well as equations estimated from relative standard utility value and utility values measured by different instruments, but the degree of fitting was not high. Conclusion: The utility values of the same subject measured by different instruments are quite different. The results of the study could provide correction reference to the utility value measured by single instrument in the absence of absolute standard.

OBJECTIVE:To understand the trend of cost and amount of consumption of antihypertensives,antidiabetics,antipsychotics and antibiotics in Shanghai.METHODS:The data of above-mentioned 4 sorts of drugs were collected from analysis system of drug-use of Shanghai in 1994～1999.The cost of each sort of drug was calculated in term of fixed price of 1994 and the amount of consumption was discount to DDDs.RESULTS:The total cost and total amount of consumption of these 4 sorts of drugs assumed a tendency towards increase and the growth rate of the former exceeded that of the latter.Antibiotics were the highest in cost;antidiabetics and antipsychotics were the highest in growth rate;antihypertensives were maximum in amount of consumption and antidiabetics were the highest in growth rate of consumption.CONCLUSION:In Shanghai,the total cost of these four sorts of drugs increased rapidly and the prices of drugs rose year by year.The spectrum of diseases has changed to some extent.

Objective To grasp the features of the macro health economic operation in China in the 1990s. Methods The method of retrospective analysis was used to compare the tendencies of increase in the total health costs, medical expenses, costs of medical services and expenses for medicine in China from 1990 to 2000. Results The total health costs in China were constantly on the increase, with an average annual increase rate of 13 33%. Medical expenses also showed a tendency of accelerated increase from 1993 on, with an average annual increase rate of 10 83%. The average annual rates of increase in costs of medical services and expenses for medicine were respectively 14 14% and 11 07%. From 1994 on, the rate of increase in the above indexes was apparently higher than the growth rate of GDP. Conclusion Although some effects have been achieved through "total quantity control and structural readjustment", the health economic situation in China remains to be further improved when compared with developed countries.

Objective To find out about the increase in the expenses of drugs as well as the changes of prices, manufacturing costs, and the distribution of profits in the manufacturing process so as to provide basis for the reform and perfection of the control of drug prices. Methods Using the method of retrospective sampling, investigations were made into the prices of drugs extensively used clinically throughout the country from 1995 to 2002 and analyses were conducted into the manufacturing and operating status of 80 pharmaceutical companies in 18 provinces of the nation and profits and other relevant influencing factors in 48 drug wholesaling enterprises in 20 provinces of the nation in 1999. Results The increment speed of the expenses of drugs in the 90s of the 20 th century in China was above 10%, higher than the increment speed of the GDP; the price index of drugs was on overage higher than the general price index; and the complete manufacturing costs of drugs accounted for 54% of their retail prices. Conclusion The prices of drugs in China might be regarded as appropriate, and yet too large an amount of profits goes into the process of circulation, resulting in insufficient funds for the pharmaceutical industry to conduct research and development.

Objective: To analyze the atrial fibrillation(AF) and the burden of illness(BOI) led by AF, to scientifically recognize the current situation of management and treatment for AF, to provide scientific references for designing the AF prevention and control strategy for Chinese people and effectively improve the reasonable allocation of medical resources. Methods: The disability adjusted life years(DALY)was used to evaluate the BOI of AF. The method of population attributable risk percent-age was applied to estimate the treatment cost of AF cerebral apoplexy. Results: In China, the loss of DALY brought by AF was 4 599 687 yuan, which is higher than the loss of DALY brought by hypertensive heart disease(3 348 925 yuan)and close to the loss of DALY brought by diabetes(4 769 127 yuan). The DALY of group over 30 is 7.15/1000 person. Cerebral apoplexy is the main reason for the BOI of this disease. It is estimated that the annual treatment cost of AF cerebral apoplexy is 4.9 billion yuan(about 800 million dollars), 89%of treatment cost come from patients over 60 years old with AF and cerebral apoplexy. Conclusion: AF brought heavy BOI to Chinese society. Cerebral apoplexy is the main reason for the burden of this disease. The loss of DALY led by AF cerebral apoplexy is more than the BOI of many chronic disease in India and European countries. The diagnosis and treatment cautious of AF need to be strengthened. The correct treatment results in restoring sinus thymes, so as to decrease complication like cerebral apoplexy. That would be the target of AF treatment in future China.

Objective:To analyze the impact of Recombinant Human Tumor Necrosis Factor-α Receptor Ⅱ:IgG Fc Fusion Protein (rhTNFR:Fc) on medical insurance budget.Methods:Rheumatic drugs were select from the IMS data 2015.The drug quantity unit was converted to defined daily dose(DDD).The quantity of rhTNFR:FC in IMS data 2015 was taken as the baseline.The expenditure growth and its impact on rheumatic drugs and all drugs were calculated under 90％ and 80％ reimbursement rate as the different incremental proportion of the quantity of rhTNFR:Fc.National health insurance expenditure data was derived from statistical data of government departments.Results:According to 90％ reimbursement rate,medical insurance expenditure increased by 5.22～10.43 billion yuan.rheumatic drugs and all medical insurance drugs expenditure increased by 63.44～126.87％ and 0.04～0.08％ respectively while the consumption of rhTNFR:Fc increased 0-100％ in 2015.The increment of medical insurance expenditure reduced accordingly under the reimbursement ratio of 80％.Conclusion:The budget impact of rhTNFR:Fc was great on medical insurance expenditure of rheumatic drugs,which was very limited on the medical insurance expenditure of all drugs.

There is a unification of the social pooling accounts and personal saving accounts of Urban Employees' Basic Medical Insurance ( UEBMI) in Shanghai. In recent years, the revenue and expenditure of UEBMI funds increased, and the fund balance sprouted year by year, and mostly concentrated in personal health insurance saving accounts. On the whole, the vast majority of insured personal saving accounts have balances, but the balance is not high, i. e. less than 1000 yuan accounted for 52. 3%. Judging from the age group, the personal health insur-ance saving account funds is mainly concentrated in the 30-year-old and over working population. Because of its par-ticularity, the personal health insurance saving accounts can only be invested in current deposit (bank live), time deposit and national debt, bonds and other hedge. Compared with the price index devaluation, the personal health insurance saving accounts somehow failed to give full play to the personal attributes. It is suggested to explore the use function of personal health insurance saving accounts by establishing family saving accounts-family coexistence, pur-chasing of supplementary medical insurance and so on. Simultaneously, the channels of maintaining and increasing the value of personal health insurance saving accounts could be broadened.

OBJECTIVE:To provide references for the controlling of reimbursement of medicare drug expenditure in urban employees in China.METHODS:Referenced experiences were summed up from classified drug reimbursement acts in other countries and areas stated in the literature review.RESULTS&CONCLUSION:It is a common international policy to clas?sify drugs by quality and adopt different reimbursement ratio;most of the countries and areas would exclude the reimburse?ments of over-the-counter drugs;the purpose of classified drug payment and reimbursement was to increase the users'payment thereby to lessen the burden of the authorities on the expenditure of social medicare drugs;concerning the controlling of drug expenditure,measures only taken from the aspects of price setting,ratio of reimbursement and quantity of drug con?sumption can that be effective;analysis about advantages and disadvantages should be considered in the making of the re?forming policies about establishing pharmaceutical reference prices and setting up prescription fee and etc.

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.