Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China

Abstract The National Centralized Drug Procurement (NCDP) policy has played a crucial role in China’s healthcare reform, aiming to enhance drug affordability and accessibility. This study investigated outpatients’ knowledge, attitudes, and practices (KAP) regarding the National Centralized Drug Proc...

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Main Authors: Yijie Ma, Yu liu
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-98967-0
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author Yijie Ma
Yu liu
author_facet Yijie Ma
Yu liu
author_sort Yijie Ma
collection DOAJ
description Abstract The National Centralized Drug Procurement (NCDP) policy has played a crucial role in China’s healthcare reform, aiming to enhance drug affordability and accessibility. This study investigated outpatients’ knowledge, attitudes, and practices (KAP) regarding the National Centralized Drug Procurement (NCDP) policy in North China. Conducted from September to November 2024, this cross-sectional study utilized online questionnaires in tertiary hospitals to assess KAP scores among 393 participants, comprising 185 (47.07%) males and 231 (58.78%) who visited outpatient clinics 1–2 times per year. A structured questionnaire was designed based on national policies and expert consultation, covering demographic characteristics, knowledge, attitude, and practice dimensions. The survey was conducted using the Wenjuanxing platform, with strict quality control measures to ensure data accuracy and completeness. Statistical analyses, including Spearman’s correlation and structural equation modeling (SEM), were performed to explore the associations between KAP variables. The mean scores were 3.51 ± 3.38 for knowledge (range: 0–12), 22.50 ± 4.31 for attitude (range: 7–35), and 32.48 ± 5.01 for practice (range: 11–55). Significant positive correlations were found between knowledge and attitude (r = 0.266, P < 0.001), knowledge and practice (r = 0.551, P < 0.001), and attitude and practice (r = 0.435, P < 0.001). Structural equation modeling revealed that knowledge directly influenced both attitude (β = -0.304, P = 0.006) and practice (β = 0.602, P = 0.009), with an indirect effect on practice through attitude (β = 0.076, P = 0.009). These findings indicate a structured relationship between knowledge, attitudes, and practices, suggesting that interventions targeting knowledge improvement may have cascading benefits on attitudes and behaviors. Overall, outpatients displayed insufficient knowledge, moderate attitudes, and low engagement with the NCDP policy, emphasizing the need for systematic educational campaigns, improved policy communication, and strategies to enhance patient involvement in decision-making regarding centrally procured medicines.
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spelling doaj-art-58936de928bc4ec2b31f29adb1920a222025-08-20T04:01:35ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-98967-0Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North ChinaYijie Ma0Yu liu1Department of Pharmacy, Taiyuan Central HospitalDepartment of Pharmacy, Taiyuan Central HospitalAbstract The National Centralized Drug Procurement (NCDP) policy has played a crucial role in China’s healthcare reform, aiming to enhance drug affordability and accessibility. This study investigated outpatients’ knowledge, attitudes, and practices (KAP) regarding the National Centralized Drug Procurement (NCDP) policy in North China. Conducted from September to November 2024, this cross-sectional study utilized online questionnaires in tertiary hospitals to assess KAP scores among 393 participants, comprising 185 (47.07%) males and 231 (58.78%) who visited outpatient clinics 1–2 times per year. A structured questionnaire was designed based on national policies and expert consultation, covering demographic characteristics, knowledge, attitude, and practice dimensions. The survey was conducted using the Wenjuanxing platform, with strict quality control measures to ensure data accuracy and completeness. Statistical analyses, including Spearman’s correlation and structural equation modeling (SEM), were performed to explore the associations between KAP variables. The mean scores were 3.51 ± 3.38 for knowledge (range: 0–12), 22.50 ± 4.31 for attitude (range: 7–35), and 32.48 ± 5.01 for practice (range: 11–55). Significant positive correlations were found between knowledge and attitude (r = 0.266, P < 0.001), knowledge and practice (r = 0.551, P < 0.001), and attitude and practice (r = 0.435, P < 0.001). Structural equation modeling revealed that knowledge directly influenced both attitude (β = -0.304, P = 0.006) and practice (β = 0.602, P = 0.009), with an indirect effect on practice through attitude (β = 0.076, P = 0.009). These findings indicate a structured relationship between knowledge, attitudes, and practices, suggesting that interventions targeting knowledge improvement may have cascading benefits on attitudes and behaviors. Overall, outpatients displayed insufficient knowledge, moderate attitudes, and low engagement with the NCDP policy, emphasizing the need for systematic educational campaigns, improved policy communication, and strategies to enhance patient involvement in decision-making regarding centrally procured medicines.https://doi.org/10.1038/s41598-025-98967-0National centralized drug procurementOutpatientsKnowledgeAttitudesPractices
spellingShingle Yijie Ma
Yu liu
Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China
Scientific Reports
National centralized drug procurement
Outpatients
Knowledge
Attitudes
Practices
title Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China
title_full Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China
title_fullStr Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China
title_full_unstemmed Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China
title_short Knowledge, attitudes, and practices of outpatients regarding National centralized drug procurement policy: a multicenter cross-sectional study in North China
title_sort knowledge attitudes and practices of outpatients regarding national centralized drug procurement policy a multicenter cross sectional study in north china
topic National centralized drug procurement
Outpatients
Knowledge
Attitudes
Practices
url https://doi.org/10.1038/s41598-025-98967-0
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