Objective: This systematic review aimed to discuss the effects of a zero-markup policy for essential drugs (ZPED) on healthcare costs and utilization in China in the years 2015–2021.Methods: We searched the PubMed, Embase, Scopus, and CINAHL databases for all associated studies carried out from January 1, 2015, to May 31, 2021, without any limitations regarding the language the studies were written in. To prevent selection bias, gray documents were tackled by other means. The methodological approaches were assessed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Newcastle-Ottawa Scale (NOS) collaboration tool.Results: Forty studies were selected at first and then 15 studies that met the inclusion criterion. Most of the studies showed a considerable decrease in total medical spending and drug spending in both outpatient and inpatient services. After the implementation of ZPED, studies showed that the medical services increased and total hospital income sustained, despite a decrease in drug revenue. Minimal or no government subsidy is required from a financial perspective.Conclusions: Although, the government could implement ZEPD with lower medical cost and drug cost to patients, and sustained income for health facilities, we have limited understanding of whether the increase in medical services was induced by the provider or was a response to unmet needs in the population. Further, studies using rigorous and advanced methods to study health policy, patient behaviors, provider behaviors, and government decisions are warranted.

Background:Anxiety in patients receiving palliative care is a noteworthy concern because it may affect their quality of life. Aromatherapy has been widely utilized to improve anxiety among patients receiving palliative care.Objective:To investigate the effectiveness of anxiety improvement in patients receiving palliative care by comparing the intervention group (aromatherapy massage) with the control group (common massage alone).Methods:A literature search was performed using PubMed, Cochrane Library, Embase, MEDLINE, and CINAHL for all related studies from inception through November 30, 2018 without restriction on language. A quantitative synthesis of randomized controlled trials (RCTs) was conducted to compare the difference in effectiveness scores between the aromatherapy massage and only common massage groups by employing a random-effect model.Results:We included three RCTs with a total of 160 participants (81 in the intervention group and 79 in the control group) in our systematic review and conducted a quantitative synthesis. The secondary data from the reviewed trials were then pooled using a random-effect model. Anxiety (mean difference = −2.60 [95% confidence interval: −7.82, 2.63], P = .33) was assessed using anxiety scores from the State-Trait Anxiety Inventory.Conclusion:Compared with common massage alone, aromatherapy massage does not provide significant effectiveness of anxiety improvement among patients receiving palliative care.

Objective. This systematic review is conducted to synthesize recent empirical evidence of Zero-markup Policy for Essential Drugs Effect on Medical Treatment in China. Methods. We searched the PubMed, Embase, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for all related studies published from inception to 30 April 2019 without restriction on language. In addition, grey literatures were captured through other sources, such as OpenGrey and Open Access Theses and Dissertations (OATD), to avoid selection bias. Methodological quality were evaluated using the PRISMA statement the Newcastle Ottawa Scale Collaboration tool. Results. Thirty-four full texts were initially searched, but only nine studies met our inclusion criteria. Most of studies indicated the significant reduction for both the total expense and drug expense per visit. Additionally, outpatient and inpatient services indicated increasing trends in annual patient-visits. Conclusions. In conclusion, the available limited, relative low-quality evidence does not support the long-term association between zero-markup policy for essential drugs and reduced medical expenditure. Further longitudinal studies that provide data for hospitals over a wider range of regions would make the economic effects more discursive.