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Determinants on aged population’s health expenditures in China

Chinese Journal of Health Policy.2015;(7):68-73. doi:10.3969/j.issn.1674-2982.2015.07.011

Objective:To provide references for policy-making on the establishment of a sound healthcare sys-tem for China’s aged population. Methods:Based on the framework of The Behavioral Model of Health Services Use and data from China Health and Retirement Longitudinal Study in 2011 , the Tobit model of aged population’s health expenditures is built. Results: Self-rated health conditions, chronic disease, medical insurance, endowment insur-ance, self-rated living standard, age, gender, marital status and urban-rural character are the significant determi-nants. Conclusions:The healthcare system for China’s aged population should be built through simultaneously apply-ing disease prevention and access facilitation policies and the characteristic differences of different groups of aged pop-ulation should be taken into consideration.

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Medicine reference price system in Germany and its implication for healthcare payment stand-ard in China

Feng CHANG ; Penglei CUI ; Qiang XIA ; Jianyun ZHANG

Chinese Journal of Health Policy.2015;(7):55-60. doi:10.3969/j.issn.1674-2982.2015.07.009

It is significantly important but difficult to establish healthcare payment standard system in case our country has cancelled government and government guidance prices. In 1989, Germany was the first country to intro-duce the medicine reference price system in Statutory Health Insurance. It does not only aim to regulate the medicine prices, but also defines a reimbursement level for a cluster of products considered to be therapeutically equivalent, and has a good influence on lowering the price of medicine. This paper systematically reviews the medicine reference price system in Germany, including four aspects:the reference price system overview, the reference price groups’ de-termination procedure, the reference prices calculation and the co-payment mechanisms. Based on the Germany refer-ence price system, we can establish healthcare payment standard in over-the-counter or chronic market first, then sci-entifically divide the reference price groups, formulate and adjust payment standard based on the market price, and perfect the co-payment mechanism to avoid moral hazard.

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The policy process analysis of thalassemia prevention strategy based on policy stream theory in Guangxi

Yuan HUANG ; Na LI ; Lili CHEN ; Anhong OU ; Yingyao CHEN

Chinese Journal of Health Policy.2015;(7):49-54. doi:10.3969/j.issn.1674-2982.2015.07.008

Thalassemia is a genetic disease with a high-incidence rate which has influenced the health condi-tions of newborns in south China. In this paper, we analyze the policy process of thalassemia prevention strategy in Guangxi based on John Kingdon’s policy stream theory, discussing the problem, policy and political flows of the strat-egy and analyzing how does the policy window open. We found that the thalassemia prevention policy was based on the deep understanding of the women and children’s health conditions, and the policy entrepreneur had made a pro-gram for alleviating to and eradicating the problem. In the condition of deepening health system reform, the thalasse-mia prevention policy in Guangxi had attracted the attention of policy makers. At a right political time for policy-mak-ing, the three above mentioned flows came in bond pushing the policy window open. As long as the thalassemia pre-vention policy process is analyzed based on the policy stream theory, it could be a good theoretical and practical ex-ample for other public health policy analysis in China.

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A review on how to better implement National Essential Public Health Services Program in China

Tongyu HU

Chinese Journal of Health Policy.2015;(7):43-48. doi:10.3969/j.issn.1674-2982.2015.07.007

Chinese government launched National Essential Public Health Services Program since 5 years ago;a program of which the progress, achievement, challenges and a knowhow for a better implementation are concerned by the related policy makers, implementers and researchers. Based on the years of experience in this area, combining literatures and reports relevant to this program, this paper summed up its background and progress, analyzed prob-lems and challenges as well as put forward the policy recommendations for a better implementation of the work. The results were mainly described in three different ways as follows:firstly, the public health service delivery system was formed;secondly, services types and target population were annually increased; and thirdly, there were remarkable health and social benefits. However, for such a big program that is related to multiple government departments and health institutions, contradictions may emerge during implementation. Therefore, it is important to deal with its dif-ferent relationships. Recommendations for further implementation of the work in the coming “Thirteenth-Five-Year”plan are enlightened to deepen a perfect essential public health service delivery mechanism from the financing and management, service package scoping, service delivery system and approach, and performance evaluation facets.

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Family physician integrated health care plan and payment system in Taiwan Province

Li KUANG ; Yixin ZENG ; Luwen ZHANG ; Tianlong MA

Chinese Journal of Health Policy.2015;(7):26-35. doi:10.3969/j.issn.1674-2982.2015.07.005

Under National Health Insurance system ( NHI) , Taiwan implemented “Family Physician Integrat-ed Health care Plan” by focusing on the key functions of primary medical institutions and family physicians. This plan had continuously strengthened the family physician system and the quality of integrated health care provision. Taiwan’s achievements and experiences were valuable for Mainland China. This paper first introduced the health sys-tem and health care provision system of primary medical institutions in Taiwan from the aspects of financing, pay-ment, health care delivery system structure, and market-capture institutions. Then, we made a comprehensive intro-duction on the policy objectives, organization structures, operation system, service schemes and health insurance pay-ment system of this plan. Finally we proposed the suggestion for integrated health care provision system in Mainland China. It is of vital importance that government should design the integrated service provision system by focusing on the key functions of family physicians. It is also of equal significance that the health administrative departments should cooperate with health insurance administrative departments to gain sufficient policy and funding resources for the plan’s successful implementation.

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China’s participation of global environment and health governance:Opportunities, challenges and policy recommendation

Haibin ZHANG ; Jingyan CHEN

Chinese Journal of Health Policy.2015;(7):21-25. doi:10.3969/j.issn.1674-2982.2015.07.004

China faces opportunities and challenges as well when it participates in global environment and health governance. Major opportunities are as follows:(1) The convergence between global environment and health governance’s future trend and China’s environment and health strategies is a strongest incentive to push China to par-ticipate in global environment and health governance;(2) China can benefit from this participation in term of more access to international resources; ( 3 ) Global environmental and health issues are the areas that can best illustrate China’s international image as a responsible member; ( 4 ) Since global environmental and health governance is still young, early participation will give China a louder voice in its decision-making. The challenges that China faces are as follows:(1) Huge pressure from domestic environment and health challenges forces China to be primarily inward-looking and makes it very hard for the country to keep a high profile in global environment and health governance. China also faces the increasing international pressure. ( 2 ) The lack of global environment and health governance strategy prevents China from effectively participating in global environment and health governance. (3)“The Grand Health Outlook”hasn’t been fully established yet in China, leaving much room for improvement. (4) Intellectual sup-port is inadequate. (5) Some countries have too high expectations of China in terms of its contribution to global envi-ronmental and health governance. In order to effectively participate in this field, China should undertake coordinated planning on both the international and domestic scenes, and take some specific policies both at national and interna-tional level.

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Understanding the linkage of environment and health:A case study of China

Wangyun HU ; Haibin ZHANG

Chinese Journal of Health Policy.2015;(7):16-20. doi:10.3969/j.issn.1674-2982.2015.07.003

Since 1949 , the linkage of environment and health in China has been mainly reflected in the is-sues, knowledge, policy and laws, organizations and the interactions between domestic and external factors, featuring the increasing expansion and complexity. The weak and inefficient environment and health governance institutions and the poor environment and health problems coping ability are the two major challenges that face the current environ-ment and health governance in China.

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The linkage of global environment and health:Deepening of the scientific understanding

Zhifang WANG ; Jingyan CHEN ; Haibin ZHANG

Chinese Journal of Health Policy.2015;(7):1-7. doi:10.3969/j.issn.1674-2982.2015.07.001

This paper introduces and analyzes the changes of scientific understanding in the linkage of global envi-ronment and health from historical and environment perspective, emphasizing on the fact that:the environmental issue im-pacts on human health are attracting an increased attention and emphasis from the international community;the existing re-search has fully proved a clear causal relationship between environmental issues which constitute one of the major factors that lead to a variety of human diseases and human health risks;the environmental issues effects on health quantified at the global level are the highlights and difficulties in the related research, differences in the current research methods and con-clusions exist internationally, but quantitative research is popular; the integration perspective of the existing scientific knowledge and global policy is a huge challenge placed in front of the global environment and health governance.

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Experience from translation mechanisms in the NICE health technology assessment to NHS de-cision making

Binyan SUI ; Xueran QI

Chinese Journal of Health Policy.2015;(7):74-78. doi:10.3969/j.issn.1674-2982.2015.07.012

The National Institute for Health and Care Excellence ( NICE) is taken for the typical success in u-sing health technology assessment to control cost increase. For other countries in a budget constrained context, this health technology assessment process and knowledge translation mechanism might be of significant implications. The objective of this paper is to provide some hints of knowledge translation to evidence-based decision making by sharing the experience from the NICE health technology assessment.

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Methodological selection strategy analysis on medicine price index

Fangfang MA ; Jing WU

Chinese Journal of Health Policy.2015;(7):61-67. doi:10.3969/j.issn.1674-2982.2015.07.010

Objective:To review methodology of medicine price index methodology and provide methodological implications for empirical researches. Methods:Based on the recent original home and abroad researches, the price index formulas, the medicine product definition, price and quantity units were introduced in this paper together with their merit/demerit and different selections’ measurement bias. Results: The measurement results were significantly different along with selections of the different weighted price index formulas. The medicine product definition and the price/quantity units in the formulas were different as well. By taking into account the new products entry and the ol-der ones exit updating issue, and by considering the products quality changes issue can also have an important empir-ical implication for the price measurement. Conclusions:The medicine price index methods need to be deeply devel-oped and the researchers should devote to further research and perform accurate measurement. In the empirical analy-sis, researchers can use different methods to measure the medicine price index in order to more accurately reflect the medicine price level change.

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