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Investigation and factor analysis of hunting intention for rural grassroots of medical students in Gansu Province

Xiuxia LI ; Tao YUAN ; Xin XING ; Jingyun ZHANG ; Wenjing GU ; Min YIN ; Zhiyuan CHENG ; Bin MA ; Kehu YANG

Chinese Journal of Health Policy.2016;9(9):71-77. doi:10.3969/j.issn.1674-2982.2016.09.013

The aim of the present research was to investigate and analyze the hunting intentions of medical students for rural grassroots in Gansu and to provide a reference for decision-making on rural health human resource . A questionnaire is the research tool which was used to investigate the views of the senior students from six medical schools , and we studied their employment willingness to rural healthcare institutions .Chi-square test and non-condi-tional logistic regression analyses were used for data analysis .A sample of 600 medical graduates was involved in this investigation.The results of this study show that more than a half (55.6%) of the students would like to work in ru-ral, but only 13.8%of which were “very willing” to work at the rural healthcare institutions .According to the out-comes of this investigation , the number of junior college students who would like to work at the grassroots was 2.3 times the number of the undergraduate students .Medical students whose monthly salary expectations were not high ,with the household registration in rural areas , and having a better understanding of the policy of rural grass-roots em-ployment were more likely to work at the rural healthcare institutions .Based on the findings of this investigation , it can be concluded that the grassroots medical career intention of medical students is not only influenced by its own fac -tors, such as education and household registration , but also the policy of the government , school employment guid-ance and social atmosphere play an important role .The above-mentioned factors should be considered by decision-making and management departments of public healthcare .The departments should introduce a reasonable recruit-ment policy and strengthen the construction of grass-roots medical technology , equipment , and infrastructure , im-prove the grass-roots of employment environment and career development opportunities and strengthen the medical students'employment guidance work to make medical students more willing to work at rural healthcare institutions .

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Analysis on working intention in rural areas and its influence factors of medical students in western medical colleges from the perspective of urban and rural comparison

Jinlin LIU ; Ying MAO

Chinese Journal of Health Policy.2016;9(9):65-70. doi:10.3969/j.issn.1674-2982.2016.09.012

This paper intends to analyze the working intention in rural areas and its influence factors of medical students .A random sampling method was used to select the sample for the study .This investigation was conducted on the medical students of grade 3 to 5 in undergraduate medical schools , junior medical colleges and technical seconda-ry medical schools from 10 western provinces .The methods of exploratory factor analysis , chi-square test , one-way ANOVA and binary logistic regression analysis were used to make the data mining .As per the results of this study , 52 .1%of the sample medical students have the working intention in rural areas .The working intention of the medical students with rural hukou (56.4%) is significantly higher than that of the medical students with urban hukou (42. 7%) .The influencing factors mainly include hukou , basic conditions of working unit , core conditions of working u-nit, gender, type of medical college, family income level, and major.In conclusion, to further expand the recruit-ment number and scope of medical students with rural hukou , and to promote the working intention in rural areas of medical students to be translated into practical working behavior , improving the core conditions of medical institutions in rural areas , and loosening and lower the recruit standards and conditions to some extent when hiring the new medi -cal workers should be viewed as some of the strategies to use .

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Policy implementation of targeted admission medical education program in rural areas

Dan HU ; Chukang CHEN ; Chao ZHANG ; Mingyu HUANG ; Jingya WANG ; Zonglin JIA ; Hong LI ; Xiaoyun LIU

Chinese Journal of Health Policy.2016;9(9):60-64. doi:10.3969/j.issn.1674-2982.2016.09.011

This study aims to investigate the current situation of the enrollment , training model and career planning of medical students in the targeted admission program .After analyzing the implementation process of this targeted admission policy in medical education , we raised some feasible strategies to increase the attraction and reten-tion of health professionals in rural China .The study covered 4 medical universities in central and western China .A cohort of 308 medical graduates from this targeted admission program were recruited in June 2015 .A baseline survey , including questionnaire survey , in-depth interviews and the focus group discussions , were conducted right before their graduation .The first follow-up online survey was done 6 months after their graduation .he findings of this investiga-tion show that 72.9%of the investigated students in the program used to live in rural areas before 15 years old.The average annual household income was 28,200 Yuan.The top three reasons of choosing this program were guaranteed job after graduation , low performance in the college entrance examination , and wavier of tuition fee .There were sig-nificant differences of implementation of this policy between different provinces , especially the contract-signing and job deployment .Income and working environment were the main influencing factors of the medical graduates 'job-see-king intention .Based on the findings of this study , it can be concluded that the targeted admission program is rather successful in attracting medical graduates for rural health services .However , extra efforts are needed to improve the implementation of the policy and to retain the medical graduates in rural area .

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International comparative study of ADR compensation system and its implications in China

Qunhong SHEN ; Shiqing ZHANG ; Shiyue CUI

Chinese Journal of Health Policy.2016;9(9):41-46. doi:10.3969/j.issn.1674-2982.2016.09.008

In recent years , increasing use of drugs has given rise to more and more Adverse Drug Reaction ( ADR) cases in China.However, due to the absence of ADR compensation legislation in China , these victim's rights cannot be restituted.By analyzing experiences from Germany , Sweden, Japan, USA, and Taiwan, as well as the current situation and difficulties of ADR compensation in China , this paper provides suggestions for ADR compensa-tion policy in China , which is to constitute an ADR compensation system based on funds .

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A comparative analysis of centralized drug procurement in China

Wujie ZOU ; Xiaodong GUAN ; Chunxia MAN ; Zhigang GUO ; Lili MA ; Yi LIU ; Luwen SHI

Chinese Journal of Health Policy.2016;9(9):35-40. doi:10.3969/j.issn.1674-2982.2016.09.007

In this research paper , we intend to come up with making proposals to centralized drug procurement in each province in China .Document consultations about drug centralized procurement in each province in 2015 were used to collect information and this information was further summarized and comparatively analyzed .From the results , it's clear that each province has designed an implementation plan based on the No .7 and the No.70 documents. When carrying out the centralized procurement , the practice on organizational structure , procurement classification , procurement with quantity , drug distribution and payment collection in each province vary from one province to anoth-er.In view of the observed results , it is worthwhile that each province should centralize its tender and procurement system , explore new ways for involving health insurance department in centralized drug procurement , implement joint reformation for public health services , medical insurance and medical production-circulation , and oppose regional protection in any form to ensure the success and equity of centralized drug procurement .

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The enlightenment of the pilot results of “Medical and Pharmaceutical Separation” in Beijing city on th e reform of public hospitals:A case study of Beijing Chaoyang Hospital

Yong CHEN ; Hang YIN

Chinese Journal of Health Policy.2016;9(9):31-34. doi:10.3969/j.issn.1674-2982.2016.09.006

This paper aims at evaluating the effectiveness of the “Medical and Pharmaceutical Separation” re-form in Beijing in three years , and put forward suggestions for the reform of public hospitals .Using data obtained from hospital database, we compared changes in the proportion of drug cost , the average drug expenditures per time, medical workload , quality , income and structure .The key findings of this study show that after the reform , the quali-ty of medical services has improved .Compared to one year before the reform , in the third year of reform the outpa-tient and inpatient medicine accounted for decreased to 16.98%and 13.3%, from 25.57%and 36%, respectively;and the outpatient and inpatient patients per capita medical expenses decreased by 21.39%and 34.8%respectively. The health care revenue increased by 68 .1%compared with before reform .Drug revenue fell 14.29%before the re-form.Medical service fee income reached 243,500,000 yuan.Income from medical examination and laboratory tests in-creased by 52.60%.Based on the findings of the present investigation , the Trial“Medical and Pharmaceutical Separa-tion” to control the cost of drugs achieved good results .Therefore ,it would be advantageous in adopting the reform of public hospitals in the next step toward the medical examination separated , adjust the price of medical services ,etc.

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Private medical institutions in China:Status quo, dilemma and rethinking

Wenmin LI ; Changqing WANG

Chinese Journal of Health Policy.2016;9(9):7-12. doi:10.3969/j.issn.1674-2982.2016.09.002

In recent years , the increasing number of private medical institutions in China has not led to the re-sponding increase in medical services , capital asset scales .The competitive situation between public and private medical institutions has not yet been formed .This paper discusses the difficulties that Chinese private medical institu-tions have encountered in overseas capital inflow , in order to foster local private medical Institutions , as well as the development of private non-profit hospitals .Based on a systematic analysis of the key points in policy , suggestions were proposed in regarding with enhancement of top-level design of the policies , encouragement of the development of off-shore or on-shore small-scale private medical institutions , as well as facilitation of the productive factors flow in medical institutions'operation.The suggestions on the policies are to be referenced in decision making for a healthy development of Chinese private medical institutions .

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China's social non-profit medical institutions:Motivations, challenges and countermeasures

Keyong DONG ; Dong ZHANG

Chinese Journal of Health Policy.2016;9(9):1-6. doi:10.3969/j.issn.1674-2982.2016.09.001

Social forces participating in non-profit medical institutions will help to insist on the commonweal of public medical and health care and realize the goal of access to basic medical and health services for everyone .At present , social forces participating in non-profit medical institutions have made some prominent improvements under a series of policy support .However , due to the absolute dominance of public hospitals , social forces participating in non-profit medical institutions are still potting a lot of restrictions on access threshold of basic medical services , devel-opment space and policy implementation .In order to promote the healthy development of social forces participating in non-profit medical institutions , we should first recognize its significance and guarantee its development potential , tal-ents construction and development space through implementing preferential policies , improving supervision mecha-nisms, exploring multi-sited license, optimizing allocation of resources and so on .

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Assessment and rational thinking of “Bidding Group” in Chinese centralized drug procure-ment system

Jinxi DING ; Rui DONG ; Wei LI ; Bojun GONG ; Junyan WANG

Chinese Journal of Health Policy.2016;9(9):52-59. doi:10.3969/j.issn.1674-2982.2016.09.010

In 2015 , policy reforms on centralized drug purchasing system have been released one by one , and the quality of medicines has been highly valued .Centralized drug purchasing system distinguishes different qualities of drugs mainly through bidding grouping , in order to achieve “uality priority”.However , there are yet some existing problems in group bidding policy at present , such as lack of a unified hierarchy , no scientific indicators and so on , which inevitably weaken the leading role of centralized purchasing policy over the quality of medicines .This paper , focuses on the study of group bidding , and the existing main problems are found through the statistical analysis of rel-evant policies introduced in different provinces .Finally, it explores some optimization strategies for “Group Bidding”which is of paramount importance .

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Analysis of the high value medical consumables procurement in foreign countries and its inspi-ration to China

Yongfa CHEN ; Xiaojuan HUANG

Chinese Journal of Health Policy.2016;9(9):47-51. doi:10.3969/j.issn.1674-2982.2016.09.009

The main intention of this paper is to propose suggestions for optimizing China 's high-value medical consumables centralized procurement .In this paper , we have analyzed the developed countries 'best practices in high-value medical consumables procurement from the perspectives of procurement principle ( s), key procurement bodies, procurement patterns, supervision, and management.The results of our analysis show that “Value for mon-ey” is the core principle in procurement and hospital route , national/regional centralized route ( s) , and group pur-chase organization ( GPO) route are four primary procurement patterns in foreign countries .Procurement management is optimized through improving product coding system and encouraging health technology assessment ( HTA) and clin-ical practitioners'involvement in procurement decision-making.In that perspective, it's been suggested that China's high-value medical consumables centralized procurement could be improved from three aspects:referring partial HTA indicators so as to enhance tender evaluation and realize value-based purchasing;establishing a standard and unified coding system for medical devices;introducing GPO route and make market surveillance mechanism into full play .

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