Impact Of Essential Medicines On The Two-way Referral And Policy Making In Chongqing Under The New Health Reformation

ObjectivesTo investigate the impact of essential medicine system (version2009)on the two-way referral system in Chongqing; to explore their associationand the best bonding point to analyze potential problems and put forwardpolitical suggestions for their coordination.MethodsMaterial sources: Literal materials were relevant articles from CNKI,Wanfang, VIP and some other databases. Government documents andrecords of interviewees who were experts in this field, people in charge ofprimary health institutes and leaderships of health department were alsoincluded. Data were collected from China or Chongqing Health StatisticsYearbook.Research methods: Data were assessed by logistic multivariate analysis.Literature review, questionnaire survey and in-depth interview were themain approaches in this research. Research ResultCurrent situations of the two-way referral and the essential medicinessystem: Wanzhou districts did better in referring patients to primary healthinstitutes. Medication and drugs comprised the main part of income forhealth institutes. Primary health institutes made a better income frommedication than drugs, especially in Community health stations.Assessment of current situation and its effects: The two-way referral oressential medicines system were not well-knew by residents. The results oflogistic multivariate analysis showed that:1) from the aspects prospective ofresidents: People’s understanding of the two-referral system was associatedwith freelancers. Whether they knew about essential medicines system wasassociated with their education backgrounds and self-payment of healthinsurance.2) From the prospective aspects of doctors: the understanding ofthe two-referral system was associated with their attitude towards essentialmedicines. And the attitude was associated with professional titles. Theimplementation of the two systems was not going well, especially for thetwo-way referral system.Suggestions were put forward and advices to solve these problems.Conclusions and Political SuggestionsPrevious studies mainly focused on the two-way referral system or theessential medicines system individually. Few investigated the essentialmedicines system on the two-referral. The development, reformation and current situation of the essential medicines (version2009) and the two-wayreferral system in China and other countries were understood byinvestigation we carried out in Chongqing. Qualitative and quantitativemethods were both used during the investigation. The effects of essentialmedicines system on the two-way referral were understood through simpleand stratified random sampling, questionnaire and on-the-spot investigation.While the effects were got known by interviewing. Main factors of theeffects were analyzed by statistic models. Above all, we put forward severalsuggestions for policy making.