BMJ Open
The effect of the national essential medicines policy on health expenditures and service delivery in Chinese township health centers: evidence from a longitudinal study
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Manuscript ID: Article Type:
Date Submitted by the Author:
Complete List of Authors:
BMJ Open bmjopen-2014-006471 Research 26-Aug-2014
Secondary Subject Heading:
Health policy, Health services research, Health economics
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Keywords:
Health policy
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Primary Subject Heading:
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zhang, xin; harbin medical university, school of public health Wu, Qunhong; Harbin Medical University, School of Public Health Liu, Guoxiang; Harbin Medical University, School of Public Health Li, Ye; Harbin Medical University, School of Public Health Gao, Lijun; Harbin Medical University, School of Public Health Fu, Wenqi; Harbin Medical University, School of Public Health Hao, Yanhua; Harbin Medical University, School of Public Health Cui, Yu; Harbin Medical University, School of Public Health Huang, Weidong; Harbin Medical University, School of Public Health Coyte, Peter; University of Toronto, Institute of Health Policy, Management and Evaluation
PRIMARY CARE, HEALTH ECONOMICS, HEALTH SERVICES ADMINISTRATION & MANAGEMENT, Health policy < HEALTH SERVICES ADMINISTRATION & MANAGEMENT
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on For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
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The effect of the national essential medicines policy on health expenditures and service delivery in Chinese township health centers: evidence from a longitudinal study Xin Zhang,1 Qunhong Wu,1 Guoxiang Liu,1 Ye Li,1 Lijun Gao,1 Wenqi Fu,1 1
Hao,
1
Yu Cui,
1
Weidong Huang,
Peter C. Coyte
1
Harbin Medical University, Harbin, China
1
University of Toronto, Toronto, Canada
Yanhua
2
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Correspondence to:
Qunhong Wu:
[email protected]; Guoxiang Liu:
[email protected]
Abstract
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Objectives: The government of China has introduced the National Essential Medicines Policy
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(NEMP) in the new round of health system reform. The objective of this paper is to analyze whether the NEMP can play a role in curbing the rise of medical expenditures without disrupting the availability of health care services at township hospitals in China.
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Design: This study adopted a pre-post treatment-control study design. Difference-in-differences methods and fixed-effects model for panel data were employed to estimate the effect of the NEMP.
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Setting: Chongqing, Jiangsu and Henan Province, in China in 2009 and 2010. Participants: 296 township health centers.
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Outcome measures: outcomes for health expenditures were average outpatient drug expenses per visit, average inpatient drug expenses per discharged patient, average outpatient expenses per
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visit and average inpatient expenses per discharged patient. Outcomes for care delivery were the numbers of visits per certified doctor per day and the numbers of hospitalized patients per certified doctor per day.
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Results: The township health centers that were enrolled in the NEMP reported lower drug expenditures for outpatient care, 12% (p
