Prescribing behaviour of village doctors under China's new cooperative medical scheme

Sun, Xiaoyun, Jackson, Sukhan, Carmichael, Gordon A. and Sleigh, Adrian C. (2009) Prescribing behaviour of village doctors under China's new cooperative medical scheme. Social Science and Medicine, 68 10: 1775-1779. doi:10.1016/j.socscimed.2009.02.043

Author Sun, Xiaoyun
Jackson, Sukhan
Carmichael, Gordon A.
Sleigh, Adrian C.
Title Prescribing behaviour of village doctors under China's new cooperative medical scheme
Journal name Social Science and Medicine   Check publisher's open access policy
ISSN 0277-9536
Publication date 2009-05-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.socscimed.2009.02.043
Open Access Status DOI
Volume 68
Issue 10
Start page 1775
End page 1779
Total pages 5
Editor Annandale, E
Place of publication United Kingdom
Publisher Pergamon
Language eng
Subject C1
140208 Health Economics
Abstract In 2003, China introduced a new community-based rural health insurance called the New Cooperative Medical Scheme (NCMS). In 2005, to assess the NCMS effects on village doctors' prescribing behaviour, we compared an NCMS county and a non-NCMS county in Shandong Province. We collected information from a representative total of 2271 patient visits in 30 village health stations (15 per county). The average number of drugs prescribed (4.6 in the NCMS county vs. 3.1 in the non-NCMS county) and use of antibiotics (72.4% vs. 59.3%) and injections (65.1% vs. 56.3%) were high in both counties, and higher in the NCMS county. Within NCMS villages, prescribing for insured vs. uninsured patients showed a similar pattern with more drugs, antibiotics and injections for those insured. Overall, for NCMS patients, the prescription excess was about equal in value to their 20% fee discount. We conclude that over-prescribing is common in villages and worse with NCMS health insurance, raising concerns for health service quality and drug-use safety. We propose that the NCMS should be redesigned with incentives for service quality improvement. A stricter regulatory environment for doctors' prescriptions is needed in rural China to counter irrational drug use.
Keyword China
Village doctor
New cooperative medical scheme
Prescribing behaviour
Health insurance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Economics Publications
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Citation counts: TR Web of Science Citation Count  Cited 36 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 03 Sep 2009, 18:01:17 EST by Mr Andrew Martlew on behalf of School of Economics