To introduce the definition, applicable scenarios, methodology and examples of mixed methods systematic reviews, aiming to promote the application of mixed methods in China and to help clinical decision-makers to select appropriate qualitative results from systematic reviews to guide clinical practice.
China has accumulated abundant experience on how to deal with post-disaster mental problem in recent years. However, the relevant concepts about post-disaster mental health services, detailed contents and process of the services were still incomplete. In order to provide guidance for the implementation of post-disaster mental health services, optimize service process, and improve service experience, the development of management practice of post-disaster mental health service is warranted. The authors give some suggestions on developing the management practice.
The shortage of health workforce in rural and remote areas has been commonly concerned by every country around the word. It is one of world health issues, challenging the aspirations of achieving equity. In this regard, WHO developed the Global Policy Recommendations to improve the accessibility of the health workforce in rural and remote areas through improved retention. This article focuses on the key steps of the policy guideline developed from evidence-based medicine methodology and from angle of guideline development, mainly about background, issues, evidence retrieval and selection, quality grading of evidence, and the forming of recommendation plan, in order to further explore how to correctly understand, obtain, evaluate and apply currently available research evidence, and how to use the GRADE system to make scientific and feasible recommendations in the decision-making process, emphasizing the importance of evidence and the GRADE system in the evidence-based health decision-making.
Objective To analyse the content and structure of the health management policy text for chronic obstructive pulmonary disease (COPD) in China, and to provide a reference for the optimization and improvement of subsequent relevant policies. Methods We searched for relevant policy documents on COPD health management at the national level from January 2017 to December 2023, constructed a two-dimensional analysis framework for policy tools and chronic disease health management processes, coded and classified policy texts, and used content analysis method to analyze policy texts. Results Twenty-four policy texts were included. There were 183 codes for policy tool dimension, with supply based, environmental based, and demand based tools accounting for 43.72%, 47.54%, and 8.74%, respectively. There were 124 codes for the dimension of health management processes, with health information collection and management accounting for 12.10%, risk prediction accounting for 14.52%, intervention and treatment accounting for 66.13%, and follow-up and effectiveness evaluation accounting for 7.26%. Conclusions At present, the proportion of policy tools related to the management of COPD in China needs to be dynamically adjusted. Environmental tools should be appropriately reduced, the internal structure of supply tools should be optimized, the driving effect of demand tools should be comprehensively enhanced, the coupling of COPD health management processes should be strengthened, and the relevant policy system and overall quality should be continuously improved.
Objective To systematically review and conclude the healthcare reform policy in rural China throughout the past 62 years. Methods This study was applied with PICOS structure to formulate research issues. National/ministry policies and documents on healthcare reform in rural China were systematically collected. The primary healthcare issues and healthcare reform measures carried out at each stage were studied, and, the criteria as population healthcare indicators, indicators for healthcare workforce and infrastructure in rural areas, healthcare expenditure indicators, and the results of national surveys for healthcare service were used to evaluate the reform performance achieved at each stage. Results A total 396 national policies on healthcare reform in rural China were included through comprehensive search. In accordance with the results of quantitative analysis on literatures, characteristics of economy system reform at each stage as well as actual advancement on healthcare reform, the reform courses of healthcare system in rural China in this study were divided into six periods as follows: national economy recovery and adjustment period, cultural revolution period, early stage of economy system transition, initial stage of healthcare reform, middle stage of healthcare reform, and implement stage for new rural cooperative medical system (NRCMS). The average policies of each period increased year by year, which generally showed as features as laying more emphasis on medical services than medicine, and thinking little of medical insurance. The population health indicators, sickbeds per thousand rural population and medical practitioners kept improving gradually. Yet the import of market mechanism and influence of international economy condition led to the decline in public welfare of healthcare system, increase of personal expenditure proportion among general healthcare cost, and duplicate content among some polices.Conclusion Commonwealth orientation is the fundamental principal to fulfill healthcare service system, thus performance on policies should be concluded in combination with the present national conditions, future requirements as well as evidence-based policy-making, and additionally, such performance should be improved during implementation.
National Center for Medical Service Administration of National Health and Family Planning Commission of China was established at the beginning of 2015. It is mainly in charge of developing and managing standards of medical technology and organizing their implementation, and giving technical guidance and consulting for evaluation of medical institutions. The foundation of the center fills in the blank of lacking central administrative department of the guideline development and evaluation. This paper introduces the definition and the function of clinical practice guideline, and analyzes the current situation, problems and challenges of domestic guidelines, and proposes some potential suggestions on improving the quality of Chinese guidelines from national level for promoting the standardization, scientification and transparency of clinical practice guidelines in China.
As an important part of social governance, the health poverty alleviation plays a key role in promoting Healthy China Strategy. This paper reviews the practice progress of health poverty alleviation in China, and summarizes it's four action logics. It is found that the governance effect is restrained by several issues, such as pessimistically external governance environment, single governance subject, poor leading role of the pilot areas, specific practices inconsistent with conceptions, and the research has not paid enough attention to the incentive system and supervision mechanism of the practitioners. Based on the above, this paper proposes five governance principles on the governance of health and poverty alleviation: evidence-based principle, systematic principle, economic principle, dynamic principle and people-oriented principle. Lastly, we hope to provide some preferences to promote the governance practice of health poverty alleviation.
Objective The modification of Chinese patent medicines (CPM) instructions is currently the focus of national drug regulation, with policies and regulations being established. Nevertheless, the policies pertaining to CPM instructions have not been thoroughly investigated. This study analyzes the direction and current issues with existing policy items to give a reference for future optimization and adjustment of policies linked to CPM instructions. Methods The official website of the National Medical Products Administration (NMPA) and National Health Commission (NHC) were searched to collect policy documents related to the CPM instructions issued at the national level in China from January 1st 2000 to June 1st 2024. Based on the classification of policy tools (supply-based policy tools, demand-based policy tools, environment-based policy tools) and the dimension of policy development (policy planning, policy implementation, policy supervision, and policy evaluation ), a two-dimensional analytical framework of "policy tools and policy process" was constructed by using the content analysis method and the quantitative analysis method, and policy documents were analyzed. Results The 27 policy texts included in the analysis generated 104 policy entries in total, wherein, environment-based policy tools (74.04%) were used the most in the dimension of policy tools, followed by demand-based policy tools (24.04%) and supply-based policy tools (1.92%). In the dimension of policy development, policy planning tools, policy implementation tools, policy supervision tools, and policy evaluation tools accounted for 24.04%, 52.88%, 17.31%, and 5.77%, respectively. An in-depth analysis of the content of the policy entries discovered that the existing policy took into account the specification of the content of the instruction and the standardization of the expression of writing, the instruction application guidance, etc, and more and more attention was being paid to the content of the characteristics of TCM in the instruction. Conclusion Currently, there is an insufficient amount of policy documents on CPM standards, which are overly focused on environment-based policy tools and the policy implementation process. To achieve the policy goal of regulating and applying CPM specifications, it is recommended to create a balanced and coordinated structure of policy instruments, emphasise the direct promotion and pulling effect of supply and demand, increase the weight of policy evaluation and supervision, and develop a standard system for evaluating CPM specifications.
In the context of actively coping with aging, China has introduced a series of health care integration policies. Using the advocacy coalition framework theory, this paper aims to analyze the process of health care integration policy changes in China from three dimensions: policy beliefs, external events and policy learning. The policy subsystem of health care integration in China includes two coalitions: top-down cascade promotion and bottom-up absorption and radiation. External events and policy learning triggered policy change, where policy learning included endogenous learning within the coalition and exogenous learning between the coalitions. A policy impasse occurs when the two advocacy coalitions are at odds, and policy brokers and professional forums can get rid of the policy impasse. In the process of policy change in China’s health care integration, the two major advocacy coalitions have reached a certain consensus. It is recommended to alleviate the problems in the integration of health care by strengthening the external factors in the change of health care policy, enhancing the policy learning in the change of health care policy, and making full use of the information resources in the change of health care policy, so as to promote the high-quality development of the integration of health care.
Precision poverty alleviation is the key task of China’s development, and its accuracy needs to be ensured in the implementation process. From the perspective of policy tools, this article defines the types of precision health poverty alleviation policy tools and explains the specific tools included in each type. Precision health poverty alleviation includes precision identification, precision implementation and precision assessment. This article also analyzes the selection of policy tools in different links. On this basis, combined with the choice of policy tools and the actual development of China, the problems in the application of different types of policy tools are summarized, and corresponding suggestions are put forward based on the existing problems. The purpose of this article is to providea reference for promoting the implementation of precision health poverty alleviation policies.