原创力文档availability and use of essential medicines in china manufacturing, supply, and prescribing in shandong and gansu provinces可用性和使用基本药物在中国制造,供应,并在山东和甘肃处方.pdfVIP
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availability and use of essential medicines in china manufacturing, supply, and prescribing in shandong and gansu provinces可用性和使用基本药物在中国制造,供应,并在山东和甘肃处方
Chen et al. BMC Health Services Research 2010, 10:211
/1472-6963/10/211
R E S E A R C H A R T I C L E Open Access
Research article
Availability and use of essential medicines in China:
manufacturing, supply, and prescribing in
Shandong and Gansu provinces
1 2,3 4 5 5
Wen Chen* , Shenglan Tang , Jing Sun , Dennis Ross-Degnan and Anita K Wagner
Abstract
Background: The current health care reform in China launched in 2009 tackles the problem of access to appropriate
medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the
reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in two
provinces.
Methods: We conducted surveys in 2007 of all manufacturers (n = 253) and of 59 purposively selected retail and 63
hospital pharmacies in Shandong and Gansu provinces to assess production and supply of products on the 2004
National Essential Medicines List (NEML), as well as factors underlying decision making about production and supply.
We also reviewed prescriptions (n = 5456) in health facilities to calculate standard indicators of appropriate medicines
use.
Results: Overall, manufacturers in Shandong and Gansu produced only 62% and 50%, respectively, of the essential
medicines they were licensed to produce. Of a randomly selected 10% of NEML products, retail pharmacies stocked up
to 60% of Western products. Median availability in hospital pharmacies ranged from 19% to 69%. Manufacturer and
retail pharmacy managers based decisions on medicines production and stocking on economic considerations, while
hospital pharmacy managers cited clinical need. Between 64% and 86% of prescriptions contained an essential
medicine
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