| Objective The implementation of National Essential Medicine System is one of the five assignments of the new health care reform. This paper focuses on Gaochun, which is one of the firstling pilot counties in Jiangsu province. The objectives of the research are as follows:firstly, to discuss the theoretical basis of evaluation for the effect and impact of essential medicine system; then, to learn about the particulars of the implemention of essential medicine system and related policies in Gaochun based on field survey; finally, to discuss the major factors which influence the effect and develop specific proposals for improving embodiment of the essential medicine system.Methods collect existing materials and carry out Quantitative survey by self designed questionnaire for sample institutions and personnel, while qualitative survey was promoted through individual interviews. The data was collected from2009to2011. Sample institutions include community health centers and community health stations. According to policy evaluation theories, results of filed survey were described and analyzed to evaluate the effect and impact of the policy.Results Based on the results of the study, conclusions were drawn as follows: Positive results:the price of per prescription reduced while the medicine supply system is improved day by day.The prescribing behavior of doctor was gradu ally reasonable;the government finance aid ratio increased year by year while t he phenomenon "drug-maintaining-medicine"is significantly weakened. Problems: essential medicines are hard to meet the demands of people;the service quantit y and efficiency of community health service institutions in Gaochun decreased obviously, which seriously influenced the functions of community health servi ce institutions;the policy of Pay-for-Performance have not been implemented,wh ich leading to the low motivations of the medical staff;the salary of village do ctors are insufficient;there are many difficulties in the developing of performan ce accessment;essential medicine system is lack of publicity.Policy suggestion In order to meet the needs of the public,There should be re asonable adjustments on essential medicine list; Strengthening the training and supervision in rational using of drugs;To improve the Pay-for-Performance syste m, thus ensure the enthusiasm of the stuff; To consummate compensation mech anism of community health service institutions and build up performance mana gement system; To strengthen the publicity of essential medicine system. |
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