Primary health care in China: is China’s health reform reform for the whole nation?

Cheng, Jingmin; Yuan, Yong-Xu; Lü, Wei; Yang, Le

doi:10.1017/s1463423617000111

“…After reform and opening up, China has accelerated the pace of economic development [ 5 -7 ]. In order to develop the health services with Chinese characteristics, China has began a long-term health system reform [8]. Health system of China has undergone a transformation from government-led to market-led mode before 2009 [9,10].…”

Section: With the Publication Of The Document On Deepening The Reformmentioning

confidence: 99%

Evaluation of the Effect of New Health Reform Policy of China Based on Prospect Theory

Guan

¹

,

Zhe

²

2020

Preprint

1

0

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Background: New health reform policy of China has gone through more than ten years from 2009 to 2019, it has come a critical period. It is important to evaluate the effect of health system reform policy, but there are a few existing studies and the researchers have not considered the impact of psychological factors on person decision-making. This study using the prospect theory can overcome this defect. Let the evaluation of the effect of new medical reform policy of China more scientific and reasonable. Methods: Data on the effect of the new health reform from China Health Statistics Yearbook and National Bureau of Statistics of China were obtained. And the indicators were selected by Corrected Item Total Correlation and Cronbach’s α reliability coefficient. The selected indicator data were calculated by the prospect theory model. Meanwhile the gray relation analysis method is introduced to enlarge the difference between the advantages and disadvantages to making the comprehensive evaluation result more obvious. Results: The results of comprehensive evaluation of the effects of health reform policies in China fluctuated from 2000 to 2017. From 2000 to 2004, the fluctuation range of the comprehensive prospect value is large; from 2004 to 2009, the comprehensive prospect value shows a slow downward trend; from 2009 to 2012, the comprehensive prospect value has decreased slightly, and then it has rebounded substantially; from 2012 to 2014, the comprehensive prospect value is stable; and from 2014 to 2017, the comprehensive prospect value is declining. Conclusions: This study showed that the implementation of new health reform policy of China has a significant impact on China's medical and health system. The new health reform advanced hard in exploration. It is worth affirming that the overall goal and direction of the new health reform are correct, but the practice is unsatisfactory. The releasing and implementation of supporting policy have the important influence on the progress of the new health reform. And the effect of the policy will decrease with the increase of the total amount. Therefore, scientific and effective late management can ensure that the policy continues to play its role.

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“…(1) Chinese government had established a relatively complete primary healthcare system in the late 1950s. (2) Under the conditions of social and economic backwardness and health resource shortages at the time, this system played an important role in protecting the health of population. (3)(4)(5)(6) However, after 1978, when a market-oriented economy reform was implemented in Chinese health sector (7)(8)(9)(10) , Chinese primitive health system had undergone tremendous changes, which mainly manifested was that the government funding in the health system has been extremely reduced (5,7,11) .…”

Section: Introductionmentioning

confidence: 99%

“…Such assessments would provide indications of the health reforms domains that are performing successfully, as well as the domains that require further attention and improvement. At present, studies mainly summarized the history and development of Chinese primary healthcare (2,3,25) , and evaluated the fairness of resource allocation and utilization of primary healthcare service. (26)(27)(28)(29)(30) However, due to the lack of support for the projects from the government, the lack of attention from researchers and other reasons, there have been few studies focusing on whether the role of primary healthcare in the overall health system is strengthened, which is the core goal of this round of health reform in China.…”

Section: Introductionmentioning

confidence: 99%

The Development Trend of Primary Healthcare after Health Reform in China

Feng

¹

,

Gong

²

,

Li

³

et al. 2020

Preprint

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Background: Re-constructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on whether the role of primary healthcare in the health system is strengthened in China.Methods: The data of this study came from the China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision, and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system.Results: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (P<0.001). However, compared the indicators in 2009, excepting for the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 4.04% for practicing (assistant) physicians, by 2.55% for nurses, by 4.06% for total revenues , by 5.54% for beds, by 7.37% for outpatient visits.Conclusion: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should improve the awareness of the importance of primary healthcare at all levels of local governments and ensure adequate financial input.

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“…At present, studies mainly summarized the history and development of Chinese primary healthcare (2,3,20) , and evaluated the fairness of resource allocation and utilization of primary healthcare service. (21)(22)(23)(24)(25) However, there have been few studies focusing on whether the role of primary healthcare in the health system is strengthened in China, which is the core goal of this round of health reform.…”

Section: Introductionmentioning

confidence: 99%

Does health reform achieve the goal of strengthening primary healthcare in China?

Feng¹,

Gong²,

Li³

et al. 2020

Preprint

0

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Background: Re-constructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on whether the role of primary healthcare in the health system is strengthened in China.Methods: The data of this study came from the China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision, and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system.Results: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (P<0.001). However, compared the indicators in 2009, excepting for the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 4.04% for practicing (assistant) physicians, by 2.55% for nurses, by 4.06% for total revenues , by 5.54% for beds, by 7.37% for outpatient visits.Conclusion: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should improve the awareness of the importance of primary healthcare at all levels of local governments and ensure adequate financial input.

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Primary health care in China: is China’s health reform reform for the whole nation?

Cited by 44 publications

References 9 publications

Evaluation of the Effect of New Health Reform Policy of China Based on Prospect Theory

Evaluation of the Effect of New Health Reform Policy of China Based on Prospect Theory

The Development Trend of Primary Healthcare after Health Reform in China

Does health reform achieve the goal of strengthening primary healthcare in China?

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