Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives

He, Alex Jingwei; Wu, Shaolong

doi:10.1007/s40258-016-0254-1

Cited by 64 publications

(64 citation statements)

References 36 publications

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“…The previous assessment of China's welfare transition under the Hu‐Wen leadership is further corroborated when considering the structural imbalance of welfare provision between rural and urban China. For instance, He and Wu () have argued that the path towards universal health insurance in China continues to be severely hampered by the existence of multiple social health insurance schemes and their limited portability across provincial lines. Focusing on the new rural co‐operative medical system for farmers, Li et al .…”

Section: Regional Fragmentation Of the Chinese Social Modelmentioning

confidence: 99%

The Productivist Construction of Selective Welfare Pragmatism in China

Mok¹,

Kühner²,

Huang

2017

Soc Policy Adm

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This article discusses whether Mainland China under the Hu Jintao and Wen Jiabao leadership has developed a new welfare settlement, the emphasis of which is to shift away from a 'productivist' focus on education and healthcare investment towards a more 'protective' approach, characterized by investing into social protection and establishing a minimum living guarantee for both the urban and rural poor. In so doing, this article reviews the conceptual debate on Chinese social policy development and explores whether there is any evidence to substantiate a gradual decrease of fragmentation in social provision among the Chinese provinces. With regard to the former question, the article finds that the various social policy initiatives have yet to amount to a qualitative shift in the core foundation of the human capital-focused welfare production logic in China. With regard to the latter question, we argue that considerable fragmentation of social provision at the Chinese provincial level continues to hamper attempts to define a coherent Chinese social model. Indeed, we find considerable diversity in terms of the co-operative state-local interactions within China leading to varying trajectories of social decentralization. Unlike much of the current research in comparative social policy analysis, which continues to treat Mainland China as a single case, this article provides a strong account of a productivist construction of selective welfare pragmatism, which reproduces social policy gaps for different groups of the Chinese population, and suggests that determining multiple 'welfare types' within China might be the most fruitful path for future academic inquiry.

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Section: Regional Fragmentation Of the Chinese Social Modelmentioning

confidence: 99%

The Productivist Construction of Selective Welfare Pragmatism in China

Mok¹,

Kühner²,

Huang

2017

Soc Policy Adm

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“…2,57 Although these policies have greatly alleviated the financial burden caused by medical costs, there is still space for improvement. 58 This explains why outpatient satisfaction with medical costs was at a lower level.…”

Section: Discussionmentioning

confidence: 99%

<p>Outpatients’ Satisfaction in the Context of 10 Years of Health-Care Reform: A Cross-Sectional Study of Tertiary Hospitals in Shiyan, China</p>

Chen¹,

Jia²,

Ke³

et al. 2020

PPA

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These authors contributed equally to this workPurpose: This study aimed to evaluate outpatient satisfaction in tertiary hospitals in Shiyan, China, to predict which items had highest priorities for outpatient satisfaction, and to identify population groups on which the medical institutions should focus. Patients and Methods: A cross-sectional survey was conducted at three tertiary hospitals in Shiyan city of China, from March to June 2018. An 18-item outpatient satisfaction questionnaire was applied. We conducted matrix analysis to describe the distribution of satisfaction score and the degree of influence of the items. Outpatient satisfaction was classified into the lowest and highest groups according to the 80/20 rule. Logistic regression model was used to identify demographic factors which might influence outpatient satisfaction. Results: A total of 2109 valid questionnaires were completed. The "waiting time", "diagnosis and treatment time" and "medical charges" items showed relatively higher degrees of influence but earned lower levels of satisfaction. Outpatients with a college level or above educational background (AOR=1.36, 95% CI=1.03-1.79) and with a family per-capita monthly income (FPMI)>7000 CNY (AOR=3.30, 95% CI=1.60-6.81) were more prevalent in the lowest satisfaction group. Outpatients with college level or above education background (COR=0.77, 95% CI=0.60-0.99), FPMI of 3001-5000 CNY (AOR=0.76, 95% CI=0.60-0.96), non-local residents (AOR=1.48, 95% CI=1.07-2.04), and urban workers with medical insurance (AOR=1.74, 95% CI=1.27-2.39) were more prevalent in the highest satisfaction group. Conclusion: The survey indicated that "long time to wait for treatment", "short treatment time", and "medical charges too expensive" were the top three aspects that need to be improved with priority by medical institutions. Education level, income level, residence and type of health insurance were the sociodemographic characteristics that significantly affect the outpatient satisfaction in tertiary hospitals. These factors need to be paid more attention by healthcare professionals to improve the patients' satisfaction.

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“…Considering the economic conditions of countries, the results of the present study show that most of the interventions have performed in the eld of nancing or nancial protection functions. Thus, most interventions in these countries have focused on the insurance system and targeted the poor people or speci c groups of society [67,75,78,[80][81][82]120]. Also one of the issues that mostly reformed by countries is the payment and premium systems [60,65,99,121].…”

Section: Discussionmentioning

confidence: 99%

Best Practices in Achieving Universal Health Coverage: A Scoping Review

Koohpayehzadeh

Azami-Aghdash

Derakhshani

et al. 2020

Preprint

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Background: Universal health coverage (UHC) is a very important and effective policy in the health system of countries worldwide. Using the experiences and learning from the best practices of successful countries in the UHC can be very helpful. Therefore, the aim of the present study is to provide a scoping review of successful global interventions and practices in achieving UHC. Methods:The present study is a scoping review study has conducted using the Arkesy and O'Malley framework. To gather information the databases of Embase, PubMed, The Cochrane Library, Scopus, SID and MagIran have searched using the keywords of Universal health coverage, Universal healthcare coverage, Universal health care coverage, Strength*, Transfer*, interventions, improve*, program*, innovations, initiative, Financing, "Service delivery", Stewardship, "Resource generation", from 2000 to 2019. Content-Analysis was also used to analyze the data.Results: Out of 4257 articles, 57 evidence finally included in the study. The results showed that of the 40 countries that had successful interventions, most were Asian. The interventions were financial protection (40 interventions that categorized to 14 items), service coverage (31 interventions that categorized to 7 items), population coverage (36 interventions that categorized to 9 items) and quality (18 interventions that categorized to 7 items) respectively. Also, the successful result were conducted financial protection (14 items), service coverage (7 items), population coverage (9 items) and quality (7 items)) respectively. Conclusion:This study provides a comprehensive and clear view of successful interventions in achieving to UHC. Therefore, with consideration to lessons learned from successful interventions, policymakers can be designing appropriate interventions to their country. a significant impact on health promotion, easier access to health care for those in need, and improved public health, especially for the poor [12].Given the importance of achieving UHC for high-and middle-income countries, the number of countries trying to achieve this has increased in the last two decades [13, 14]. In addition, nowadays countries by increasing their knowledge and awareness of strategies and applying the experiences of successful countries, as well as acquiring the necessary capabilities to meet their urgent needs, are trying to take the path of achieving UHC [15][16][17]. Like other high-income countries that have achieved UHC, low and middle-income countries, with taking into account the structure and resources that they have, on the path to UHC, undertake measures such as mobilizing resources, fulfilling the political commitments necessary to implement health-related policies, and implementing effective reforms and interventions in macro-national policies [1, 18, 19]. The UHC can be one of the most challenging political processes that require the support of various stakeholders, including health system policymakers [4]. Although all countries pursue the same goal of achieving UHC, the path...

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Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives

Cited by 64 publications

References 36 publications

The Productivist Construction of Selective Welfare Pragmatism in China

The Productivist Construction of Selective Welfare Pragmatism in China

<p>Outpatients’ Satisfaction in the Context of 10 Years of Health-Care Reform: A Cross-Sectional Study of Tertiary Hospitals in Shiyan, China</p>

Best Practices in Achieving Universal Health Coverage: A Scoping Review

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