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Wang Z, Wang R, Li X, Bai L, Fan P, Tang Y, Li X, Huang Y, Nie X, Han S, Shi L, Chen J. Influencing Factors of Generic Prescribing Behavior of Physicians: A Structural Equation Model Based on the Theory of Planned Behavior. Risk Manag Healthc Policy 2024; 17:1375-1385. [PMID: 38813068 PMCID: PMC11135567 DOI: 10.2147/rmhp.s446743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/13/2024] [Indexed: 05/31/2024] Open
Abstract
Background Although affordable generics could probably contribute to the solution of rapidly increasing pharmaceutical expenditure, those drugs are prescribed at a lower rate in China. Physicians' perception and knowledge of generics have a great influence on their prescribing behavior. Objective This study aimed to identify factors that affect physicians' generic prescribing behavior based on the theory of planned behaviors (TPB). Methods Data were collected by both electronic and paper-based surveys from 1297 Chinese physicians, and 1047 surveys were retained. The structural equation model (SEM) was employed to investigate the relationship between four behavioral constructs, namely, attitudes, subjective norms, perceived control of behaviors, and intentions. Results About 50% of Chinese physicians had a positive attitude towards generic drugs that had passed the "Consistency Evaluation of Quality and Efficacy of Generic Drugs" (high-quality generic drugs), but their knowledge of generic drugs was relatively inadequate. The path coefficients for the effect of attitudes, subjective norms, and perceived behavioral control on behavioral intention were 0.285, 0.366, and 0.322 respectively. The path coefficients for the effect of behavioral intention and perceived behavioral control on prescribing behavior were 0.009 and 0.410 respectively. Conclusion Physicians' attitudes, subjective norms, and perceived behavioral control were significant positive correlation predictors of behavioral intention. Subjective norms and perceived behavior control had a greater impact than attitude on physicians' prescribing intention. However, the generic prescribing behavior is not under the volitional control of Chinese physicians. Physicians' prescribing practice is likely affected by perceived strong control over prescribing generic drugs.
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Affiliation(s)
- Zhiyuan Wang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Ruilin Wang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Xiaoyu Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Lin Bai
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Pingan Fan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Yuanyuan Tang
- Bidding Management Office, Suqian First Hospital, Suqian, Jiangsu, People’s Republic of China
| | - Xin Li
- Department of Clinical Pharmacy, School of Pharmacy, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Yangmu Huang
- School of Public Health, Peking University, Beijing, People’s Republic of China
| | - Xiaoyan Nie
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People’s Republic of China
| | - Sheng Han
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People’s Republic of China
| | - Luwen Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People’s Republic of China
| | - Jing Chen
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People’s Republic of China
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Ding S, Liu G, Xu F, Ji K, Zhao L, Zheng X, Benjamin O, Wang Z, Yang S, Chen R. The satisfaction of elderly people with elderly caring social organizations and its relationship with social support and anxiety during the COVID-19 pandemic: a cross-sectional study. BMC Public Health 2023; 23:1206. [PMID: 37344834 DOI: 10.1186/s12889-023-15951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND With the deepening of China's aging population, higher demands have been placed on the supply of elderly care services. As one of the main sources of providing elderly care services, the quality of service provided by elderly caring social organizations (SOs) directly affects the quality of life of the elderly. In recent years, mental health issues among the elderly have become increasingly prominent, especially with the onset of the COVID-19 pandemic. Necessitating the need to pay much more attention to the social support and mental health of this population. This study, therefore, explores the mediating role of institutional satisfaction between the social support and anxiety levels of elderly people in Chongqing's elderly caring SOs. METHOD This study employed a multi-stage stratified random sampling method to survey 1004 service recipients in elderly caring social organizations from July to August 2022. The self-made sociodemographic questionnaire, institutional satisfaction questionnaire, MSPSS, and GAD-7 were used to collect data on sociodemographic characteristics, institutional satisfaction, social support, and anxiety levels of older adults. Exploratory Factor Analysis and Cronbach's alpha were used to test construct validity and scale reliability, respectively. Data features were described with One-Way Analysis of Variance, while Multiple Linear Regression and Structural Equation Modeling were used to evaluate relationships between social support, institutional satisfaction, and anxiety levels. RESULTS The average institutional satisfaction score for elderly people in elderly caring SOs was 48.14 ± 6.75. Specifically, the satisfaction score for environmental quality and the satisfaction score for service quality were 16.63 ± 2.56 and 31.52 ± 4.76, respectively. In terms of socio-demographic variables, the presence of visits from relatives, personal annual average income, and self-rated health status all have significant effects on anxiety. Elders who receive visits from relatives have lower levels of anxiety compared to those who do not. Personal annual average income and self-rated health status are negatively correlated with anxiety levels. Social support had significant positive effect on institutional satisfaction, while institutional satisfaction had significant negative effect on anxiety. Institutional satisfaction partially mediated the relationship between social support and anxiety. CONCLUSIONS Our research demonstrates that improving the quality of organizational services in elderly caring SOs and increasing institutional satisfaction among the elders has significant potential for reducing anxiety levels among the elderly. Additionally, the social support by visits from family members cannot be overlooked. We encourage increasing the frequency of family visits through various means to enhance the support provided to elderly individuals.
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Affiliation(s)
- Shuo Ding
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Guoqing Liu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Fuqin Xu
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Kai Ji
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Lanlan Zhao
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Xin Zheng
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Otsen Benjamin
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
- Registrars' Department, University of Cape Coast, Cape Coast, Ghana
| | - Zhengsheng Wang
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China
| | - Shufan Yang
- School of Computing, Engineering and Built Environment, Edinburgh Napier University, Edinburgh, UK
- Research Department of Orthopaedics and Musculoskeletal Science, University College London, UCL, London, UK
| | - Ren Chen
- School of Health Services Management, Anhui Medical University, Hefei, 230032, China.
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Qu J, Zuo W, Wang S, Du L, Liu X, Gao Y, Li J, Pan H, Du X, Mei D, Took RL, Schafermeyer KW, Lukas S, Zhang B. Knowledge, perceptions and practices of pharmacists regarding generic substitution in China: a cross-sectional study. BMJ Open 2021; 11:e051277. [PMID: 34663661 PMCID: PMC8524276 DOI: 10.1136/bmjopen-2021-051277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate pharmacists' knowledge, perceptions and practices towards generic substitution in the 11 pilot locations in China. DESIGN An online cross-sectional survey using questionnaires was conducted. A convenience sampling technique was implemented to recruit pharmacists. SETTING AND PARTICIPANTS The study took place in medical institutions of 11 pilot locations that participated in the pilot national centralised procurement programme in 2019. Two thousand two hundred and ninety-one pharmacists including hospital pharmacists or community pharmacists based on health-systems or clinics participated in the study. RESULTS Most of the participants had the good knowledge of requirements for evaluating the quality and efficacy of generic drugs (n=2118; 92.4%), and the definition of generic drugs (n=2078; 90.7%). In terms of perceptions, 67.3% of respondents were of the opinion that generic drugs are equally as effective as the brand-name drugs, and 69.0% of respondents were of the opinion that generic drugs are as safe as brand equivalents. A high percentage of participants supported the policy of generic substitution (n=1634; 71.4%). A significant positive correlation was demonstrated between total knowledge score and total perception score (ρ=0.267; p<0.001). Efficacy, safety and the direction of national policies and hospital regulations were the main factors affecting pharmacists' willingness to dispense generic drugs. CONCLUSIONS The study identified gaps in respondents' knowledge and perceptions of generic substitution. Pharmacists who are more knowledgeable in generic drugs tend to hold a more supportive attitude towards generic substitution. Although it appeared that pharmacists in China have largely accepted generic substitution, they still have concerns regarding the reliability and quality of generic drugs. The current issues need to be addressed for the realisation of the true value of generic drugs as part of the country's healthcare cost-containment strategy as well as the implementation of generic substitution policy in China.
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Affiliation(s)
- Jinghan Qu
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Wei Zuo
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Shaohong Wang
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Liping Du
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Xin Liu
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Yang Gao
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Jiantao Li
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Hui Pan
- Department of Medical Administration, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Xiaoli Du
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Dan Mei
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Roxane L Took
- Department of Pharmacy Practice, St. Louis College of Pharmacy, St Louis, Missouri, USA
| | - Kenneth W Schafermeyer
- Department of Pharmaceutical and Administrative Sciences, St. Louis College of Pharmacy, St Louis, Missouri, USA
| | - Stephanie Lukas
- Department of Pharmaceutical and Administrative Sciences, St. Louis College of Pharmacy, St Louis, Missouri, USA
| | - Bo Zhang
- Department of Pharmacy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
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Li Y, Huang L, Xiang L, Dou D. The influence of medical insurance and social security cards on the floating population's settlement intention. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2021; 19:68. [PMID: 34627281 PMCID: PMC8501933 DOI: 10.1186/s12962-021-00321-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 09/23/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Medical insurance and social security cards are an important incentive for the floating population to live a stable life in their current residence, but there has been little studies on their effect on settlement intentions. Therefore, the purpose of this paper was to study the impact of basic medical insurance for urban employees and application for personal social security cards on the settlement intentions of the floating population. With the increase of the desire to settle, the health management and the development of public health will be improved. METHODS Based on the 2017 survey data from the dynamic monitoring of China's floating population, we explored the influence of basic medical insurance for urban employees and social security cards on the floating population's settlement intentions. Additionally, this study also examined the comprehensive causal relationship, with social integration as the mediator variable. We used SPSS 21.0 software. The input method was used to analyze the influence of the above variables by binary logistic regression. Then we used AMOS22.0 software to establish the structural equation model of the relationship between the above three independent variables. Finally, we used bootstrapping method to analyze the direct effect, indirect effect and total effect of independent variables on settlement intention. RESULTS The settlement intention of members of the floating population after participating in basic medical insurance for urban employees was 23.2% higher than that of those who did not participate. The decision as to whether to apply for a personal social security card is related to their settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention were positive values, and the Z values of the overall effect, indirect effect, and direct effect were all greater than 1.96; the confidence interval of the indirect effect did not include 0. We found that this model is a partial intermediary model, with an intermediary ratio of 10.66%. CONCLUSIONS This article highlights the important impact of basic medical insurance for urban employees and individual social security cards on the floating population. The conclusions of this study provide suggestions for the government to use when designing policies to enhance the settlement intentions of the floating population and to improve the development of public health undertakings.
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Affiliation(s)
- Yulin Li
- School of Nursing and Health, Institute for Chronic Disease Risk Assessment, Henan University, Kaifeng, 475004, China
| | - Lingling Huang
- School of Nursing and Health, Lida University, Shanghai, 201609, China
| | - Li Xiang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Dongmei Dou
- School of Nursing and Health, Institute for Chronic Disease Risk Assessment, Henan University, Kaifeng, 475004, China.
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Deng S, Yang N, Li S, Wang W, Yan H, Li H. Doctors' Job Satisfaction and Its Relationships With Doctor-Patient Relationship and Work-Family Conflict in China: A Structural Equation Modeling. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 55:46958018790831. [PMID: 30371128 PMCID: PMC6207965 DOI: 10.1177/0046958018790831] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The objective of this study was to evaluate the relationship of doctors’ job satisfaction with doctor-patient relationship and work-family conflict in China. The data came from a cross-sectional survey in Hubei province, which was part of China’s Fifth National Health Services Survey conducted in 2013. The survey in Hubei covered 54 secondary and tertiary general hospitals distributed in 20 counties. Of the 1080 questionnaires, 908 were included into our analysis. After surviving from reliability and validity tests, structural equation modeling was applied for further analysis with SPSS 20.0 and Mplus 7.0. The results showed that the average score of job satisfaction is 19.61 out of 30 points, indicating a relatively low level of doctors’ job satisfaction in Hubei province. Work-family conflict was found to have negative impact on doctors’ job satisfaction, and good doctor-patient relationship was found to have positive impact on their job satisfaction. Therefore, hospital administrators and policy makers should make effort to design and implement strategies that focus on meliorating doctor-patient relationship and balancing doctors’ work and family life to further improve their job satisfaction.
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Affiliation(s)
- Shumin Deng
- 1 School of Health Sciences, Wuhan University, China
| | - Ningxi Yang
- 1 School of Health Sciences, Wuhan University, China
| | - Shiyue Li
- 1 School of Health Sciences, Wuhan University, China
| | - Wei Wang
- 1 School of Health Sciences, Wuhan University, China
| | - Hong Yan
- 1 School of Health Sciences, Wuhan University, China
| | - Hao Li
- 1 School of Health Sciences, Wuhan University, China.,2 Belt and Road Health Research Institute, Wuhan University, China
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