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Effect of health care priec reform on medical expenditure and cost of health insurance：An a-nalysis of county hsopitals in Nanjing, Jiangsu province

Hanming HUANG ; Li LI

Chinese Journal of Health Policy.2014;(5):56-62. doi:10.3969/j.issn.1674-2982.2014.05.010

Objectives:This paper evaluates the rationality and feasibility of pharmaceutical price reform in dis-trict public hospitals in Nanjing .Methods:Pharmaceutical expense data before and after pharmaceutical price reform was collected from databases , changes of some major index about expenditures of medical insurance fund was simula -ted.Results:In Jiangning district hospital which had been reformed ,inpatient and outpatient expenses decreased while patient burden rate was the same or changed only slightly .Under the same stimulation , in four other district hospitals which is about to reform , the drug proportion of inpatient and outpatient and outpatient expenses per -time decreased , while inpatient expenses per-time increased .The hospitalization burden rate decreased by 3 .21%, and health insurance expenditure of inpatient accounted for 7 .74%of the whole fund pool .Conclusions:Pharmaceutical price reform reduced patient financial burden;health insurance fund spending increased and needs more attention in order to guard against the fund risk .The structure of pharmaceutical pricing tended to be reasonable and medical technology and medical service was more helpful .Compensation rates of medical insurance weren't equal, and the higher the compensation rates , the more both patient burden and health insurance fund expenditures were .Sugges-tions:It is crucial to eradicate the system of “subsidizing hospitals by charging more medicine fees” by leading the patient to primary medical situation , pushing the implementation of hospital payment reform and uniting of city inte-gration and urban-rural integration in order to ensure scientific development of district public hospitals .

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The operation and implictaion of universal health insurance in the U nited Kingdom, Singapore and Hong Kong

Longfei YI

Chinese Journal of Health Policy.2014;(5):49-55. doi:10.3969/j.issn.1674-2982.2014.05.009

As the excellent country or region refers to medical insurance system , the United Kingdom , Singa-pore and Hong Kong are often the focus of international academic circles .However , the difference is that the United Kingdom is a model of free universal medical care , Singapore is a government-led mixed medical protection mode , and Hong Kong earns a worldwide reputation on health care by virtue of the high quality , low price public hospital services .This article assesses the advantages and limitations of the three medical insurance systems in terms of equity in financing , individual affordability, insurance coverage , sustainability in financing and individual responsibility , and provides a reference for health care reform in China .

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Analysis on social determinants of chronic disease of the elderly in Beijing

Shunv TANG ; Weiyan JIAN ; Yan GUO

Chinese Journal of Health Policy.2014;(5):63-67. doi:10.3969/j.issn.1674-2982.2014.05.011

Objective:This paper investigates the difference of chronic disease in different social class of the elderly in Beijing .Method: Date of a representative sample included 1717 residents aged 60 and above are drawn from Beijing elderly household survey 2013 conducted by Peking university school of public health .With income , ed-ucation , occupation and residence household as indicators of social class , logistic regression model is used for analy-zing the difference of chronic disease prevalence among different socio-economic status .Result:The non-agricultural household group , middle and highest income group , the least and highest groups of education have a lower probability and the farming , forestry, animal husbandry and fishing water production personnel before retired have a higher risk of suffering from chronic disease .In terms of multiple chronic diseases , second lowest 20%income group tie to high-er risk of suffering three or more chronic conditions simultaneously .Conclusion: Strategies development of chronic disease prevention and control should take full account of social determinants of health such as the social stratifica -tion , not just for the direct cause of chronic diseases .Agricultural household , low-income and low-education group of people should be priorities in Beijing elderly chronic disease prevention and control .

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Technological innovation, industrial policy and food safety:Evidences from“Swill-cooked dirty oil” governance

Peng LIU ; Si LIU ; Xiyao TONG

Chinese Journal of Health Policy.2014;(5):12-18. doi:10.3969/j.issn.1674-2982.2014.05.003

Although Chinese government has input a lot of financial and administrative resources to resolve the problem of “swill-cooked dirty oil”, its policy effect is not so ideal.Meanwhile , a series of challenges such as defec-tive institutional design of kitchen waste recycling and weak regulatory capacity.This paper argues that its overlook on technological innovation and industrial policy have partially led to its policy failure on this issue .Also, this paper summarizes impact factors from the perspectives of technological innovation , industrial policy and government regula-tion.A series of feasible policies include promoting business technological innovation capacity , offering financial sup-ports to industrial development , establishing a long-term plan on kitchen waste recycling and quota system for biodiesel using.Finally, it argues Chinese government should combine its regulatory policy with its technological innovation and industrial policy to achieve its dual policy goals between food safety governance and circular economy development .

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On the legislation about juveniles participatin g in the health-care food feeding test：From the perspective of the“golden rice” event

Lei FENG

Chinese Journal of Health Policy.2014;(5):7-11. doi:10.3969/j.issn.1674-2982.2014.05.002

The “golden rice” event reflects the legal defects about juveniles'protection in health-care food feeding test.In the area of Chinese law application ,there is the same legislation on the both.But the legislation is not able to reflect the significant difference in the test benefit and protect the juveniles who can not express their will properly.The legislation of the countries out of China usually distinguish the both.There are three legislative models on the non-therapeutic research in the world which is similar to feeding test , and they are the limited model ,the legal guardian-deciding model and the risk and benefit-assesing model.We should refer to the legislative purpose and spe-cific provisions on the juveniles of the models above.We should perfect the legal model of juveniles'participance in health-care food feeding test by limit in principle with individual exception.

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The design of China's food safety regulatory system and mechanism:The principle of consumer priority should be established

Yingheng ZHOU ; Renlei MA

Chinese Journal of Health Policy.2014;(5):1-6. doi:10.3969/j.issn.1674-2982.2014.05.001

Implementing the principle of consumer priority is necessary to solve the food safety problems.And China's food safety regulatory system revolution also provides the conditions for the implementation.Now the absence of consumer priority principle in our food safety regulatory system and mechanism results in China's food safety regulatory facing five problems, such as absence of government regulation , sector interests priority , regulatory incentives distorted, inadequate punishment on illegal behavior, low-efficiency information disclosure and lack of consumer education.Drawing on the food safety regulation experience of developed countries like U.S., EU and Japan, this paper points out that we should make con-sumer priority principle clear in food safety regulatory legally , and implement the principle of consumer priority in regulatory penalty system, information disclosure system and consumer education system to improve China's food safety regulation.

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China’s soft aid for health：Practices, Issues and implications：A case of health human re-source cooperation

Qianqian LIU ; Jiming ZHU ; Xiaolin WANG

Chinese Journal of Health Policy.2014;(3):58-63. doi:10.3969/j.issn.1674-2982.2014.03.011

Soft aid for health has become an important component of China's foreign aid. Soft aid for health with a focus on human resources development reflects the core spirit and the innovative mechanism of China's foreign aid. This paper examines three different types of aid for health human resources: medical assistance teams, govern-ment scholarships for students from developing countries, and health training courses for officials from developing countries. It also argues that China's foreign aid exposes problems, including insufficient strategic planning, non-in-volvement of civil society and NGOs, and lack of research on China's soft aid practices. In this paper, we suggests that to improve the effectiveness of foreign aid, the government should improve its strategic planning for aid, ensure the full public participation, strengthen the academic research, and improve knowledge sharing.

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Challenges in the U.S.healthcare system and their implications for China

Guoping XU ; Donghua LI

Chinese Journal of Health Policy.2014;(2):32-37. doi:10.3969/j.issn.1674-2982.2014.02.006

This article discusses challenges in the current U .S.healthcare system and their fundamental cau-ses.Such challenges include increasing health expenditure , deficiency and excess in health service utilization , worse health outcomes than other developed countries , and insufficient GP numbers .We suggest that mistakes in early healthcare legislation and an imperfect health management system are the primary causes for these problems .Implica-tions for China ’ s current ongoing healthcare reform are outlined .We draw on the experience in the U .S.and other developed countries but keep China ’ s unique features in mind .Factors that need to be considered in China are ensu-ring the right of healthcare for all , giving full play to the role of government and primary medical institutions , strengthening support for GPs , reforming payment modes , controlling the growth of health expenditure , strengthening legislation, and handling medical accidents and disputes reasonably .

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Dilemmas and countermeasures of private medical institutions：A case in Wenzhou, Zhejiang Province

Guilin LIU ; Lin WANG

Chinese Journal of Health Policy.2014;(5):37-41. doi:10.3969/j.issn.1674-2982.2014.05.007

In this article, we summarize the main policy on encouraging nongovernmental investors to establish medical institutions in Wenzhou , Zhejiang Province.Based on the survey of private medical institutions in Wenzhou , we find that there are still many issues that should be resolved in terms of nongovernmental investors establishing pri -vate hospitals , such as the difficulty in implementing construction projects , spending too long time applying for the medical insurance unit , the complicated application procedures of incentive funds , the unequal status with public health hospitals in financing and the development of human resource for health , and the low-level administration and social reputation.Therefore , for promoting the sustainable development of private health hospitals , it is of great im-portance to have a breakthrough in the implementation of the policy ,such as supporting policies reform , financing and talent support , strengthening supervision , and so on.

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The development of non-profit private hospitals in China：Institutional obstacles and policy suggestions

Suizhang MEI ; Hongxia HUANG

Chinese Journal of Health Policy.2014;(5):33-36. doi:10.3969/j.issn.1674-2982.2014.05.006

This paper summarizes the positive significance of non-profit private hospitals development , and an-alyzes the institutional obstacles on the development of non-profit private hospitals in terms of autonomous manage-ment, fair competition, investment and profit , tax relief, management and supervision .Finally, the paper provides some proposals to improve the development of non-profit private hospitals:revising the medical institution regulation , establishing and improving the non-profit private hospital assets finance management system , implementing the opera-tion system, establishing a scientific and standardized supervision mechanism , etc.

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