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"Changes of the usage of""motivation"" and related concepts within Chinese literature of human resources for health"

Chinese Journal of Health Policy.2015;8(3):65-71. doi:10.3969/j.issn.1674-2982.2015.03.013

After introduction into Chinese academy, and in the application in health care domain, the usage ofmotivation and related concepts has been changed. The changes were partly due to pragmatic utility, and caused confusion in the application of motivation theory in Chinese human resource for health. Both English and Chinese lit-erature was reviewed and systematic literature review was applied. We analyzed the different definitions of motiva-tion in English, and how they were used and understand in Chinese academia in history. Motivation was divided into three Chinese concepts, representing the process of motivation, inner driver of motivation and psychological state of being motivated. The other usage changes include willful exchange ofincentive andmotivation;motivationbeing used more as a means to motivate than a motivational process;the result of motivation as an aroused psychologi-cal state not seriously defined. Systematic literature review revealed the distribution of various motivation topics in Chinese literature and supported the abovementioned arguments. These changes of usage could cause barriers to re-search of human resource for health in China. It is recommended that usage ofmotivation should be clarified in ac-ademia in China and the process of motivation rather than motivation as a managerial means deserves more attention.

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Qualitative analysis on the utilization of health services and economic burden of the elderly pa-tients with diabetic foot ulcer

Hui LU ; Jianming WANG ; Jieqiong LV ; Ying WANG ; Jiqiang YUE ; Xinjuan SUN ; Aiping WANG

Chinese Journal of Health Policy.2015;8(3):60-64. doi:10.3969/j.issn.1674-2982.2015.03.012

Objective:To explore the health seeking behavior, utilization of health services and the economic burden of the elderly patients with diabetic foot ulcer ( DF) , with aim to provide policy evidence for improving their DF prevention and treatment outcomes. Methods: The purposive sampling method was applied to recruit 15 elderly DF patients treated in the 454 th Hospital of Chinese PLA from December 2013 to January 2014. After informed con-sent, they were in-depth interviewed. Results: The elderly with DF had a higher demand for the health services. They emphasized on treatment and neglected prevention. The utilization and efficiency of health services were affected by patients' economic level, medical insurance, capacity of community services, and so on. Conclusion:In order to improve the treatment outcome and quality of life for the elderly DF patients, it's necessary to strengthen patients' health education, to build a community-based and integrated health care system on DF prevention, treatment and management, and to develop the policies for reducing DF related economic burden.

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Impact of choice of living standard indicators on the equality index of health and health service utilization

Ruyan XU ; Min HU ; Lu YE

Chinese Journal of Health Policy.2015;8(3):51-55. doi:10.3969/j.issn.1674-2982.2015.03.010

Objective:To evaluate outcomes and differences of the equality indexes of health and health service utilization in different living standard indicators. Methods: Using multi-phase stratified random sampling to select samples of rural families in Ningxia region and collect data about sample families' income, consumption, wealth and some relevant data on family members' health status and health services utilization. Using concentration index to measure the equality of health and health services utilization with income, consumption or wealth index as living standard indicators respectively and discuss the differences of the outcomes. Results:For different living standard in-dicators, the correlation between each other was weak. The differences of concentration indexes with different living standard indicators between 0. 01 to 0. 21 , and most of whichweresignificant on the level of 0. 05. Conclusion: The impact of choice of living standard indicators on the equality index of health and health service utilization was signifi-cant. In a limited area, living standards measured by wealth index could be more accurate and objective than by in-come or consumption, but the condition of this method wasmore strict.

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Medical voucher system in Hong Kong and Macao and its implications to mainland China

Feng CHANG ; Qiang XIA ; Yun LU ; Penglei CUI ; Shasha YANG

Chinese Journal of Health Policy.2015;8(3):40-45. doi:10.3969/j.issn.1674-2982.2015.03.008

It is important and difficult to establish the market competition mechanism in the health care re-form. Medical voucher system in Hong Kong and Macao can provide policy guidelines for Mainland China to promote institutional innovation, force public hospital reform and the rational allocation of medical and health resources. This paper introduced the origin and development of medical voucher system. Based on the description of the implementa-tion background, similarities and differences and effects of medical voucher system in Hong Kong and Macao, the pa-per found that medical voucher system could help encourage the demander to make more frequent use of medical serv-ices, improve their consciousness of prevention and health care and promote family doctor system. Through analyzing the applicability of medical voucher system in mainland China, the paper pointed out it was consistent with the reform orientation and could be served as a useful supplement to the health care system to improve medical insurance, medi-cal assisstance system as well as an effective measure to develop private medical institutions.

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Utilization and equity of preventive care in China from 1991 to 2011

Dahai YUE ; Zhiyuan HOU ; Yuhui ZHU ; Hai FANG

Chinese Journal of Health Policy.2015;8(3):56-59. doi:10.3969/j.issn.1674-2982.2015.03.011

Objective:To analyze the influential factors, trend and equity of preventive care utilization in China from 1991 to 2011. Methods:Using China Health and Nutrition Survey ( CHNS) , logistic regression was applied to explore influential factors, study time trend of preventive care utilization, and examine its equity by Concentration In-dex. Results: Total preventive care services and physical examination utilization significantly increased. Significant inequity still exit in terms of general physical examination and blood text, however, disappeared with respect to blood pressure screening and gynecological examination. Main influential factors of preventive care utilization includes in-come, gender, education and insurance, etc. Conclusion:Preventive care utilization had significantly grown with de-creasing inequalities, but inequity still exit, particularly for general physical examination and blood test.

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Study on issues of wealth index for measurements of living standard

Ruyan XU ; Min HU ; Lu YE

Chinese Journal of Health Policy.2015;8(3):46-50. doi:10.3969/j.issn.1674-2982.2015.03.009

Objective: To study the agreement of wealth index constructed using different methods, and the comparison of living standard measurements by the wealth index and traditional indicators. Methods:The data used in the study come from Rural Household Survey in Ningxia region, and the sample of this household survey included 6612 households, 28886 people. Using different weighting methods, such as principal component analysis and equal weighting, and data coded in different ways to construct 4 wealth indexes, and analyzing the agreement of these 4 wealth indexes. Respectively comparing the wealth indexes with the living standard measurements by total, per cap-ital and per adult household consumption. Results:The wealth indexes showed strong agreement with each other, and similarly weak agreement with consumption indicators. Conclusion: the indicators of living standard measurements each had advantages and disadvantages, and there was weak agreement between these indicators. Thus, when living standard was the main study result or the social determinant of study results, the appropriate indicator in the study should be selected according to the study results by different indicators and professional knowledge and experiences.

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Evolution and perfection of the HIV/AIDS designated hospital system in China

Peng XU ; Wanying CHEN ; Lahong JU ; Liping MA ; Fan LU

Chinese Journal of Health Policy.2015;(5):67-72. doi:10.3969/j.issn.1674-2982.2015.05.012

Objective:To summarize the development of the HIV/AIDS designated hospital system, analyze the main issues and explore solutions for this system. Methods:184 leaders/experts of three levels of healthcare facilities ( provinces, cities and counties) from 30 provinces engaged in AIDS prevention and control for over five years, and 2,432 people living with HIV/AIDS(PLWHA) from seven provinces were investigated through two different question-naires. Results:According to the staff responses, the issues of surgery and hospitalization are difficult and outstand-ing for PLWHA due to the current designated hospital system with scores of 6. 49 in severity. Of the ten largest prob-lems, ranked third is the need for improved AIDS prevention and control. 2 367 (97. 3%) PLWHAs had an aware-ness of the designated hospitals, 1,376 received treatment in the designated hospitals, and 85. 5% believed that the illness was effectively treated, while 9. 0% thought that the medical technology of the designated hospital was limited;18 . 7% of hospitalized HIV/AIDS patients or those who received surgery experienced prevarication by the non-des-ignated hospitals. Policy analysis shows that China’s designated hospital system for PLWHA has developed gradually with the characteristics of periodic and temporary changes. Conclusion:The designated hospital system for PLWHA in China has played an important role, but there are still several problems. The government should improve the existing system by strengthening the comprehensive medical service capacity of designated hospitals, improving the mechanism of consultation and referrals, coordinating the non-designated hospitals to provide technical support, reducing dis-crimination and fear from medical staff against HIV/AIDS, decreasing the risk of occupational exposure, and enhan-cing the communication among hospitals, CDCs and patients.

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The problems and suggestions on policy system of private medical institutions

Xiufeng WANG

Chinese Journal of Health Policy.2015;(5):62-66. doi:10.3969/j.issn.1674-2982.2015.05.011

on the basis of systematic examination to the policy system of private medical institutions, this paper summarize the current situation and main problems of the policy system, including basic concepts, related issues a-bout the non-state owned enterprise management, important policies about the non-profit medical institutions, the ab-sence of some main policies. To solve these problems, this paper puts forward specific suggestions, such as to speed up the legislation, to make standards of non-profit medical institutions judging and qualification of exempt from tax in details, to construct the reasonable return system for the investors, to extend the tax holidays for the profit-making medical institutions, to make sure private medical institutions have equitable access to qualification in pilot hospital of healthcare insurance, to improve the transformation mechanism between Non-profit and profit-making institutions, to formulate specific measures.

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Development assistance for health in BRICS countries

Gui CAO ; Yunping WANG ; Ze FU ; Xiaodan FAN ; Nan JIN ; Wenjie LIANG

Chinese Journal of Health Policy.2015;(5):44-47. doi:10.3969/j.issn.1674-2982.2015.05.008

With the rapid economic growth and social development in the BRICS countries, the role of devel-opment assistance for health is becoming more and more significant. This paper describes the scales, recipient coun-tries, mechanisms and characteristics and management systems of development assistance for health in BRICS coun-tries. The paper suggests that a) it is necessary to set up a centralized international aid management agency;b) the mode of development assistance for health must be optimized;c) the scale of development assistance for health shall be increased ( over time);d) each BRIC country should use its own comparative advantages and development experi-ence to carry out development assistance for health while strengthening the cooperative power among the BRICS coun-tries;e) development assistance for health data should be more transparent and open;f) the evaluation of develop-ment assistance for health must be established and perfected.

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Ideology and practice of development assistance for health in China

Yunping WANG ; Wenjie LIANG ; Hongwei YANG ; Gui CAO ; Xiaodan FAN ; Nan JIN ; Xuan WANG

Chinese Journal of Health Policy.2015;(5):37-43. doi:10.3969/j.issn.1674-2982.2015.05.007

Since the establishment of the People’s Republic of China, the development of China’s official de-velopment assistance for health has been going through three phases. To date, it has developed in many forms, inclu-ding the dispatch of medical team and the construction of health facilities. Since the market reforms, the global con-text together with the domestic socioeconomic foundations have changed; the impact of China’s relatively simple and segmented development assistance for health on the development of health systems in developing countries is limited;the effectiveness of assistance has been watered-down due to segmentation and vague management and accountability systems, as well as the lack of an overarching strategy;China’s health institutions, techniques and products suffer va-rious obstacles in their transfer to other countries where rules are dominated by western countries;compared with the increasing and multiple demands of development assistance for health from developing countries, the capacities of co-operation need to be further developed. As the paper suggests, use the “new major-country” and “new morality-in-terest” and“human oriented” concepts, as well as the ideology of“aid in order to develop, develop in order to coop-erate, so as to develop hand-in-hand” to guide China’s development assistance for health;innovate stereo-aid models to adapt to the changed foreign and domestic socioeconomic context; reform the development assistance for health management system and define rights and obligations appropriately;strengthen coordination and information sharing;link development assistance for health with global health governance to promote a maximized spillover effect;mobilize the civil society with strengthened guidance and supervision.

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