Consolidating the social health insurance schemes in China: towards an equitable and efficient health system

Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health insurance schemes in fund level and benefit package. Political commitments, institutional innovations, and a feasible implementation plan are the major elements needed for success in consolidation. Achievement of universal health coverage in China needs systemic strategies including consolidation of the social health insurance schemes.

Healthy China : deepening health reform in China building high-quality and value-based service delivery

As many other countries, China faces big challenges to meet the health care needs of her citizens, associated with a rapidly aging society and increasing burden of non-communicable diseases (NCDs). Also, health costs have been growing at a rate higher than GDP growth since 2008.

Since the launch of health reform in 2009, China has invested significantly in health infrastructure at the grassroots level and made progress in building the primary care doctors system. Basic public health services capacity has been significantly enhanced. China is progressing quickly to achieving universal health coverage and some of the reform achievements have attracted worldwide attention.

The reform commanded many innovative pilots in health financing and service delivery at the local level and provided a strong foundation for the next stage of reform. This report aim to support China during this reform phase by recommending 8 sets of strategic reform directions, referred to as ...

Development of global health research in China

With the continuous deepening and broaddening of Chin´s engagement in global health as well as the transformation of its role in global health governance, global healh science have made great strides in China, from the infancy stage of last century to the grown-up stage of this century. Considerable progress in global health discipline has been witnessed, especially in the last ten years. This report analyse the three crucial indications that characterized the rapid development of global health in China

Vertical integrated service model: an educational intervention for chronic disease management and its effects in rural China – a study protocol

Chronic diseases are becoming a huge threat to the Chinese health system. Although the New Round of Medical Reform aims to improve this, the chronic disease management in rural China is still worrying as it relies highly on hospital care instead of primary care. The vertical integrated care model has proven to be effective for chronic disease patients in many high-income countries, while few studies have been conducted in China. In this project, vertical integrated care will be applied to optimize the care of patients with type 2 diabetes mellitus (T2DM) and primary hypertension in rural China, and to shift the care from hospital to primary care.

Communication Heal? Examining the Role of Patient Satisfaction and Communication Experience in China

China is facing the problem of having health care that is difficult to access. Online patient–provider communication (OPPC) may bring a new option to deliver health services. However, online communication with doctors is still novel to many people in China. Little research has been conducted to examine how OPPC could improve health outcomes. With an integrated model that incorporates social cognitive theory into the three-stage model of health promotion using interactive media, this study tested the social mechanism underlying the impact of OPPC

Understanding the determinants of public trust in the health care system in China: an analysis of a cross-sectional survey

Despite increasing research attention on public trust in health care systems, empirical evidence on this topic in the developing world is limited and inconclusive. This paper examines the level and determinants of public trust in the health care system in China where the findings suggest that low public trust in China’s health care system is a potential problem. Improving health care experiences may be the most practical and effective way of improving trust in the health care system in China.

China country assessment report on ageing and health

China is ageing much faster than other low- and middle-income countries. The proportion of the population aged 60 years and over will increase from 12.4% in 2010 to 28% in 2040. Also women outlive men, and populations in rural areas have higher proportions of older people.
Therefore, social and economic transitions are changing traditional care arrangements for older people in China. So, a health transition from communicable to noncommunicable disease is well under way in China.

The development and reform of public health in China from 1949 to 2019

Public health system plays a vital role in the development of health sector in China and protects the health of Chinese people. However, there are few comprehensive reviews and studies focusing on its evolution and reform. It is worthwhile to pay attention to the public health development in China, given that the history and structure of public health system have their own characteristics in China.

The study is a retrospective review of the development public health over seven decades in China. It presents the findings from some national or provincial survey data, interviews with key informants, reviews of relevant published papers and policy contents

Care providers, access to care, and the Long-term Care Nursing Insurance in China: An agent-based simulation

China piloted a publicly funded Long-term Care Nursing Insurance (LTCNI) with an aim to improve access to long-term care (LTC) for older people in China in 2012. Existing studies showed that the scheme has been successful in meeting some goals, but little is known on how the availability, price and quality of the local care providers affect access to care. This article founded considerable discrepancies in terms of access to services among the LTCNI beneficiaries. The poor are more likely to choose nursing home care with low costs albeit these services may be of poor quality. The demand for home-based services is high, but these services are not distributed according to population needs and are not available in some districts with high concentration of older people. 

Using an evidence-based safety approach to develop China’s road safety strategies

Road accidents are a major global public safety and health problem. Presently, many countries such as China urgently need to find better strategies to improve their road safety. This paper has two key objectives, which are: (i) to propose potential solutions to improve China’s road safety, and (ii) to provide China and other countries with helpful evidence for their future road safety.

Integrated Healthcare Systems Response Strategies Based on the Luohu Model During the COVID-19 Epidemic in Shenzhen, China

COVID-19 has affected primary health-care delivery in metropolitan areas. An integrated health-care system offers advantages in response to the community outbreak and transmission of highly infectious diseases.

On the basis of practitioner experience with a pioneering integrated health-care system in Shenzhen, China, this article presents the following effective strategies in response to the epidemic: (1) enhance the public workforce in primary health care; (2) integrate resources to allow regional sharing and efficient use; (3) employ teams centered on general practitioners for community containment; and (4) adopt e-health and telemedicine for healthcare delivery.

An integrated health-care system is usually very specific to a particular regional context; however, the core strategies and mechanisms based on the Luohu model can contribute to improving the public health capacity in emergency responses; they can transform health-care delivery in the COVID-19 epidemic.

The experience in Shenzhen may help other cities in enhancing and coordinating the preparedness ...

Dynamics of Health Technology Diffusion in the Integrated Care System (DHTDICS): A Development and Validation Study in China

Limited diffusion of health technology has greatly halted the improvement of resource integration and healthcare outcomes. The importance of understanding the dynamics of health technology diffusion is increasingly highlighted. However, the dynamic mechanism of health technology diffusion in the context of the integrated care system (ICS) remained largely unknown.

Tuberculosis treatment management in primary healthcare sectors: a mixed-methods study investigating delivery status and barriers from organisational and patient perspectives

Tuberculosis (TB) treatment management services (TTMSs) are crucial for improving patient treatment adherence. Under the TB integrated control model in China, healthcare workers (HCWs) in the primary healthcare (PHC) sectors are responsible for TTMS delivery. This mixed-method study aimed to explore the status of and barriers to TTMS delivery faced by HCWs in PHC sectors from the health organisational and patient perspectives.

Strengthening attributes of primary care to improve patients’ experiences and population health: from rural village clinics to urban health centres

Primary care is an integrated model of care underpinned by the discipline of general practice (GP), aiming to optimise population health and reduce disparities across the population. The key attributes of primary care—first contact, continuity, coordination, comprehensiveness, and community orientation and family centeredness—enable a high-value service delivery to address the wider determinants of health. In recent years, primary care transformation has taken place across the globe.

Continuity of Care and Healthcare Costs among Patients with Chronic Disease: Evidence from Primary Care Settings in China

Though critical to primary care, continuity of care has rarely been examined in China. This study aims to assess the relationship between continuity of care and healthcare costs among patients with chronic diseases within primary care settings in China.

Integrating Health and Care for Older People in China: What Has Been Accomplished? What is Next?

In China, in addition to its rapid ageing process and large older population, the incidence of chronic disease and disability in the elderly is astonishingly high. Among the 267 million people aged 60 and over in 2021, there were about 190 million people with at least one chronic disease and 40 million living with disability [1]. This has created a huge challenge for the world’s most populous country which is also a middle-income economy in caring for its senior citizens. In response to the complex needs of the elderly and drawing from international experience, China has adopted an active ageing and healthy ageing strategy, and integrating health and care has increasingly been a policy priority for coping with population ageing in the past decade. Progress has been made while challenges remain. The experiences and lessons of China might be referential for the other middle income countries in integrating health ...

Integrated Care for Older People: Theories and Practices

As the first Chinese monograph to explicitly connect the “Yiyang Jiehe” with “integrated care for older people”, this book presents readers with a thorough overview of integrated care for older people, from theoretical content, management tools, to practices in China and international learning.