Economics of health transitions in China

Liu, Gordon G.; Krumholz, Samuel

doi:10.1093/acprof:oso/9780199678204.003.0075

Cited by 2 publications

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“…services, limited by severe government intervention, failed to meet the growing demand along with the rapid economic and disease transitions (36). Economic growth increased demand beyond the state's capacity to supply health care; in addition, after the epistemological transition when the most significant disease burdens stemmed from chronic rather than communicable diseases, there was a fundamental mismatch between state-provided services and popular need.…”

Section: Yearmentioning

confidence: 99%

“…The Urban Employee Insurance program provides the most comprehensive coverage; it includes cost-sharing provisions for both inpatient and outpatient services, premiums are based on the level of the enrollee's salary, and the employer provides cost sharing (36). Urban Resident and Rural Resident Insurances are both voluntary programs in which premiums are highly subsidized by the government but coverage remains shallow.…”

Section: Insurance Policy Settingmentioning

confidence: 99%

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China's Health Reform Update

Liu

Vortherms

Hong

2017

Annu. Rev. Public Health

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218

215

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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 These shifts put significant pressure on the existing outdated, highly centralized bureaucratic system.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.

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Section: Yearmentioning

confidence: 99%

Section: Insurance Policy Settingmentioning

confidence: 99%

China's Health Reform Update

Liu

Vortherms

Hong

2017

Annu. Rev. Public Health

Self Cite

218

215

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Disparities in mental health care utilization among inpatients in various types of health institutions: a cross-sectional study based on EHR data in Shanghai, China

Shi

Tang²,

Jing

et al. 2019

BMC Public Health

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Background Reform of the health care system in China has prompted concerns about the utilization of mental health services. This study aims to compare the utilization of mental health services among inpatients in various types of health institutions in Shanghai (community health care centres, secondary general hospitals, tertiary general hospitals, and specialty hospitals). Methods Based on electronic health record (EHR) data, we extracted all of the mental hospitalization data from various types of public health institutions in Pudong New Area, Shanghai, China, from 2013 to 2016. The distribution of mentally ill inpatients and the possible factors contributing to the observed differences in these institutions were analysed. Results Specialty psychiatric hospitals in Pudong New Area, Shanghai, admitted more inpatients and treated in patients with more severe disorders (49.73%). However, those who were male (OR = 0.545), were elderly (OR = 20.133), had inferior insurance (urban social insurance for citizens: OR = 4.013; paying themselves, OR = 29.489), had a longer length of stay (OR = 1.001) and had lower costs (OR = 0.910) were more likely to choose community health centres than specialty hospitals. Those who preferred the secondary and tertiary hospitals to the specialty ones were more likely to be in the male, elderly, married, shorter length of stay and higher-cost groups. Notably, compared to those with urban social insurance for workers, those who had urban social insurance for citizens (OR = 3.136) or paid out-of-pocket (OR = 9.822) were significantly clustered in the tertiary hospitals rather than the specialty hospitals. Conclusions Inpatients who were male, were older, had inferior insurance, had a longer length of stay and had lower costs preferred the elementary health services. However, the utilization of mental health care in high-tier institutions reflected defects, especially the fact that the current health insurance system does not adequately restrict patients’ choices, and those who paid more tended to choose tertiary hospitals instead of professional specialty ones. We suggest that psychiatric services should be enhanced by instituting reforms, including public education, improved health insurance, a forceful referral system, and competency reinforcement for primary care physicians, to provide a more integrated mental health system.

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Economics of health transitions in China

Cited by 2 publications

References 0 publications

China's Health Reform Update

China's Health Reform Update

Disparities in mental health care utilization among inpatients in various types of health institutions: a cross-sectional study based on EHR data in Shanghai, China

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