China's primary health-care reform

Liu, Qian; Wang, Bin; Kong, Yaguang; Cheng, Kar Keung

doi:10.1016/s0140-6736(11)60167-0

Cited by 131 publications

(116 citation statements)

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“…The Healthy China 2030 Plan for health system reforms and a recent directive issued by the Chinese government prioritise primary healthcare and the training of GPs by enhancing incentives for trainees,3134 which are important steps forward. Nonetheless, the concept of general practice remains weak among the general public; many patients prefer to seek care at hospitals, mostly because of a lack of confidence in the quality of care provided by primary healthcare facilities 35. This highlights the importance of defining and promoting the precise role of GPs as gatekeepers to the health system 36…”

Section: Discussionmentioning

confidence: 99%

Training sufficient and adequate general practitioners for universal health coverage in China

Tam

Leung

et al. 2018

BMJ

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Section: Discussionmentioning

confidence: 99%

Training sufficient and adequate general practitioners for universal health coverage in China

Tam

Leung

et al. 2018

BMJ

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“…First, the government invested an additional US$127 billion to enhance the infrastructure of primary healthcare facilities, particularly those in the rural areas. 10 Second, government subsidies, instead of pharmaceutical revenues, would be the main financial source to support for the operation of primary care facilities. 11 In 2009, the National Essential Medicines Policy (NEMP) was launched, and one of its priorities was the Essential Medicine List (EML), which aimed to select low-cost medicine for common treatable diseases.…”

Section: Introductionmentioning

confidence: 99%

Efficiency and productivity measurement of rural township hospitals in China: a bootstrapping data envelopment analysis

et al. 2016

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ObjectiveTownship hospitals (THs) are important components of the three-tier rural healthcare system of China. However, the efficiency and productivity of THs have been questioned since the healthcare reform was implemented in 2009. The objective of this study is to analyse the efficiency and productivity changes in THs before and after the reform process.Setting and participantsA total of 48 sample THs were selected from the Xiaogan Prefecture in Hubei Province from 2008 to 2014.Outcome measuresFirst, bootstrapping data envelopment analysis (DEA) was performed to estimate the technical efficiency (TE), pure technical efficiency (PTE) and scale efficiency (SE) of the sample THs during the period. Second, the bootstrapping Malmquist productivity index was used to calculate the productivity changes over time.ResultsThe average TE, PTE and SE of the sample THs over the 7-year period were 0.5147, 0.6373 and 0.7080, respectively. The average TE and PTE increased from 2008 to 2012 but declined considerably after 2012. In general, the sample THs experienced a negative shift in productivity from 2008 to 2014. The negative change was 2.14%, which was attributed to a 23.89% decrease in technological changes (TC). The sample THs experienced a positive productivity shift from 2008 to 2012 but experienced deterioration from 2012 to 2014.ConclusionsThere was considerable space for TE improvement in the sample THs since the average TE was relatively low. From 2008 to 2014, the sample THs experienced a decrease in productivity, and the adverse alteration in TC should be emphasised. In the context of healthcare reform, the factors that influence TE and productivity of THs are complex. Results suggest that numerous quantitative and qualitative studies are necessary to explore the reasons for the changes in TE and productivity.

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“…1 Primary care initially developed rapidly under a planned economy (before the late 1970s), but later, more slowly under a marketoriented profit-seeking economy (after the early 1980s). More recent healthcare reforms 2,3 aim to use primary care delivered by community health centres (CHCs) to provide more equitable care for the whole population. CHCs are being set up in every neighbourhood within a 15-minute walking distance to ensure primary care is kept close to home.…”

Section: China's Journey To Primary Carementioning

confidence: 99%