Perceived impacts of the national essential medicines system: a cross-sectional survey of health workers in urban community health services in China

OBJECTIVES: This study aimed to investigate the perceptions of primary care workers about the impacts of the national essential medicines policy (NEMP). SETTING: A cross-sectional questionnaire survey was undertaken in 42 urban community health centres randomly selected from four provinces in China. PARTICIPANTS: 791 primary care workers rated the impacts of the NEMP on a 5-point Likert scale. OUTCOME MEASURES: An average score for the impacts of the NEMP on four aspects (the practice of health workers, interactions of patients with health workers, operations of health centres and provision of medicines) was calculated, each ranging from 0 to 100. A higher score indicates a more positive rating. Linear regression models were established to determine the sociodemographic characteristics (region, age, gender, profession, training, income) that were associated with the ratings. RESULTS: The respondents gave an average rating score of 65.61±11.76, 63.17±13.62, 66.35±13.02 and 67.26±11.60 for the impacts of the NEMP on health workers, patients, health centres and provision of medicines, respectively. Respondents from the central region rated the NEMP higher than those from the eastern and western regions. The pharmacists (β=5.457~7.558, p<0.001) and nurses (β=2.612~3.107, p<0.05) gave a more positive rating on the NEMP than their physician counterparts. A higher income was found to be associated with a decrease in the NEMP ratings. Repetitive training was a predictor of higher ratings. CONCLUSIONS: The NEMP has significant impacts (as perceived by the health workers) on health services delivery in primary care settings. However, the impacts of the NEMP vary by region, professional practice and the income level of health workers. It is important to maintain support from physicians through income subsidies (to compensate for potential loss) and training.