China's Health Reform Update

Abstract

China experienced both economic and epistemological transitions within the past few decades, greatly increasing demand for accessible and affordable health care. These shifts put significant pressure on the existing outdated, highly centralized bureaucratic system. Adjusting to growing demands, the government has pursued a new round of health reforms since the late 2000s; the main goals are to reform health care financing, essential drug policies, and public hospitals. Health care financing reform led to universal basic medical insurance, whereas the public hospital reform required more complex measures ranging from changes in regulatory, operational, and service delivery settings to personnel management. This article reviews these major policy changes and the literature-based evidence of the effects of reforms on cost, access, and quality of care. It then highlights the outlook for future reforms. We argue that a better understanding of the unintended consequences of reform policies and of how practitioners' and patients' interests can be better aligned is essential for reforms to succeed.

Price adjustment for traditional Chinese medicine procedures: Based on a standardized value parity model

“…Remuneration has changed from three avenues -service charges, additional income from pharmaceuticals, and government subsidies -to two avenues -service fees and government subsidies (19). Government financing currently accounts for around 9% of the income of public hospitals, and pharmaceuticals account for a large proportion (45%) of hospital income (20).…”

The Aging Tsunami and Senior Healthcare Development in China

“…To better understand current senior healthcare development in China, a brief discussion of China's complex, evolving healthcare system and its recent reform related to senior health and a brief historical account of geriatrics in China are in order. Figure illustrates China's healthcare reform from a historical perspective …”

“…A medical subspecialty of general practice, or general medicine, has recently been established, and the government provides fund to support training programs at Level 3A hospitals. Physicians are also permitted to practice at multiple sites or open private clinics in the community . A requirement has recently been established that Level 3A hospitals develop collaborative and referral relationships with their local community hospitals.…”

“…The new NCMS and URMI policies strongly encourage and, in some regions, demand that routine healthcare services be provided at community hospitals, with only complex and severe cases referred to Level 3A hospitals. At the same time, Level 3A hospitals should collaborate with community hospitals in training general practice physicians and providing necessary expertise . Taken together, these efforts are expected to help establish primary care networks for older adults living in the community.…”

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

“…In 2015, the reform of medical and healthcare systems focused on the reform of county-level public hospitals and solutions to the issue of compensation for medical cost through drug-selling profits, which further emphasizes the public welfare nature of medical service [1-2] . It remains unknown whether the medical institutions and the human resources cultivated by medical colleges are capable of coping with such a challenging reform in the context of major reform throughout the whole medical sector, and the complicated situation of economy and society, and especially the complicated doctor-patient relationships.…”