In order to promote the harmonization of decision-making processes in public health and the harmonization of decision-making criteria, McMaster University in Canada and the Estonian Health Insurance Fund jointly published an article on an evidence ecosystem for health decision-making in 2022 with the support of the World Health Organization. Based on the proposed health decision-making evidence ecosystem model of the article, this paper interpreted the processes and elements in the model, aiming to provide reference for evidence-based public health decision making in China.
ObjectiveTo review the characteristics of registered industry-sponsored clinical trials of pediatric drugs and vaccines in China and to provide references for promoting the development of new pediatric drugs. MethodsWe searched ClinicalTrials.gov and the Chinese Clinical Trial Registry for completed registered industry-sponsored clinical trials of pediatric drugs and vaccines from the database inception to September 11, 2022. Data including the date the trial was first posted, product type (drug or vaccine), sample size, and other information to describe the general characteristics of pediatric clinical trials were collected. The studies were divided into 2 phases based on the trial posted date, 2005―2010 and 2011―2022, reflecting the enactment of pediatric drug clinical trial policies in recent years. The quality of trial registration and the main characteristics of interventional trials in the 2 phases were then compared. Exploring the results attached to industry and non-industry sponsored clinical trials. ResultsData for 145 trials were collected, and the largest proportion (63.4%) involved vaccines. Randomized control trial (RCT) was the study type with the highest percentage (68.3%). The average report completion rate for registered interventional trials was 81.0%. Compared with 2005―2010, the percentage of average report completions, pediatric drug clinical studies, multicenter, RCTs, and double-blinded registered trials increased in 2011―2022. The proportion of positive outcomes in pediatric clinical trials sponsored by industries was higher than those sponsored by non-industry. ConclusionThe majority of completed pediatric clinical trials sponsored by industries are for vaccines, in line with the promotion of pediatric policies. The quality of trial registration has improved, but not significantly, and some characteristics of trial design have changed. The proportion of positive outcomes in pediatric clinical trials sponsored by industries is higher. And further promotion of pediatric clinical trials is needed.
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.
Comorbidity is a prominent public health problem in the elderly population. To carry out research on the comorbidity of the elderly is not only an important breakthrough to realize the national strategy of actively responding to the aging population, but also a vivid practice of earnestly implementing the "Healthy China" and other action programs. Based on the major public health issues of elderly comorbidity, this paper lists the main contents and methods of elderly comorbidity research from the perspective of secondary research and empirical research, and holds that this field contains both the profound thought of "holistic concept" and the advanced idea of "integrative medicine". At the same time, under the background of the new era, the gradual deepening of the research in this field may give birth to a brand-new discipline - geriatric comorbidity.
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.
This paper introduces the development and changes of clinical practice guidelines based on the enlightenment of the Reporting Items for Practice Guidelines in Health Care (RIGHT), and provides policy recommendations.
ObjectiveTo analyze the limitations and challenges for the use of real-world data in the decision making of drug reimbursement through literature review and provide standard process and guideline for the real-world study supporting drug reimbursement. MethodsBy summarizing the relevant policies, regulations, and guiding principles of major drug regulatory agencies worldwide, the study analyzed the applicable conditions, framework, and reimbursement mode for using real-world evidence in the decision making of drug reimbursement. ResultsThe study found that the health technology assessment departments of major developed countries and Asian countries have used real -world evidence to evaluate the drug efficacy and safety. The application scope of real-world data for reimbursement decision included describing the treatment process of the disease, assessing economic burden, verifying economic models, and evaluating the efficacy and safety of drugs. Some developed countries including the United Kingdom and the United States had released guidelines or frameworks of the real-world study for reimbursement decision. The process and framework of using real-world data in reimbursement decision could be divided into three models: coverage with evidence development, outcome-based contract, and re-assessment. ConclusionReal-world data has been widely used in the process of health technology assessment. To adapt to the development of the pharmaceutical industry and to meet the needs of clinical patients, it is urgent to standardize the process of collecting real-world data and formulate the scope and process of using real-world data in the reimbursement process.
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.
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.