Chinese health care system and clinical epidemiology

Abstract

China has gone through a comprehensive health care insurance reform since 2003 and achieved universal health insurance coverage in 2011. The new health care insurance system provides China with a huge opportunity for the development of health care and medical research when its rich medical resources are fully unfolded. In this study, we review the Chinese health care system and its implication for medical research, especially within clinical epidemiology. First, we briefly review the population register system, the distribution of the urban and rural population in China, and the development of the Chinese health care system after 1949. In the following sections, we describe the current Chinese health care delivery system and the current health insurance system. We then focus on the construction of the Chinese health information system as well as several existing registers and research projects on health data. Finally, we discuss the opportunities and challenges of the health care system in regard to clinical epidemiology research. China now has three main insurance schemes. The Urban Employee Basic Medical Insurance (UEBMI) covers urban employees and retired employees. The Urban Residence Basic Medical Insurance (URBMI) covers urban residents, including children, students, elderly people without previous employment, and unemployed people. The New Rural Cooperative Medical Scheme (NRCMS) covers rural residents. The Chinese Government has made efforts to build up health information data, including electronic medical records. The establishment of universal health care insurance with linkage to medical records will provide potentially huge research opportunities in the future. However, constructing a complete register system at a nationwide level is challenging. In the future, China will demand increased capacity of researchers and data managers, in particular within clinical epidemiology, to explore the rich resources.

Burden of atopic dermatitis in Asia

“…To understand the economic burden that AD poses in Asia, it is important to first be aware of the varied medical reimbursement systems used in different Asian countries. For the most part, many Asian countries, including South Korea, Thailand and Taiwan, pay for health care primarily through government‐funded or subsidized basic universal health care, although many also include a smaller private insurance sector (Table ) . Others may have a mixture of public and private health‐care systems, such as in India or Malaysia.…”

“…For the most part, many Asian countries, including South Korea, Thailand and Taiwan, pay for health care primarily through governmentfunded or subsidized basic universal health care, although many also include a smaller private insurance sector (Table 1). [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] Others may have a mixture of public and private health-care systems, such as in India or Malaysia. There are some notable nuances among Asian countries when it comes to paying for AD treatment.…”

Rural‐urban disparity in risk exposure to involuntary social health insurance transition in China: An investigation of chronic disease patients' mental health problems

“…UEBMI sets a minimum length of time for payment (25 years for males and 20 years for females). Those who have reached this standard can be entitled to basic medical insurance benefits without need for further payment after retirement . In contrast, URBMI and NCMS do not set a minimum payment period and need to be paid for annually.…”

Treatment patterns of prostate cancer with bone metastasis in Beijing: A real‐world study using data from an administrative claims database

“…We conducted a population‐based cohort study using data from a large medical claims database in Beijing—the Urban Employee Basic Medical Insurance (UEBMI) database. The UEBMI is one of the three main national health insurance schemes in China and is a mandatory program covering urban and retired employees . The UEBMI contains longitudinal patient data including demographics, clinical diagnoses, and prescriptions for drugs and procedures from all health care institutions in Beijing since 2008 .…”

“…The UEBMI is one of the three main national health insurance schemes in China and is a mandatory program covering urban and retired employees. 21 The UEBMI contains…”