In 2009,China initiated a new round of health reform to establish a wellfunctioning health system.The 2009 health reform did make some significant achievements in improving affordability and accessibility.In particula...In 2009,China initiated a new round of health reform to establish a wellfunctioning health system.The 2009 health reform did make some significant achievements in improving affordability and accessibility.In particular,social health insurance has been expanded significantly and various social health insurance plans have covered over 95%of total population in China by 2011.The Chinese government also has significantly increased fiscal input for health financing.However,affordability remains a serious concern as the social health insurers,as purchasers,were not very effective in containing the growth of health expenditure.Accessibility to primary care and public health is another concern.In this context,health governance reforms are necessary to address affordability and accessibility issues.Health governance set rules for key actors of the health system(including service providers,health insurers and government departments)by taking into account the strategies and incentives of these actors in their interactions.In recent years,a series of reforms in health governance have been initiated.Some progresses have been achieved.For the next stage of health reform,issues including how to further reform the governance structure of medical institutions and how to improve resource allocation in the health system are critical.展开更多
Objective:This study focuses on Hangzhou,a Chinese city with a population of nine million urban and rural residents,to examine the successful development and innovation experience of its primary health care service sy...Objective:This study focuses on Hangzhou,a Chinese city with a population of nine million urban and rural residents,to examine the successful development and innovation experience of its primary health care service system during the new health reform in China since 2009 and then dis-seminate the findings through international third parties.Methods:Measures such as data analysis,study of documents and regulations,fieldwork,and expert discussions were used to systematically investigate primary health care in Hangzhou.The findings will have a profound practical impact on the health reform for nine million rural and urban residents throughout Hangzhou’s municipal boroughs.Results:Community health services in Hangzhou are characterized as follows:They are gov-ernment led;they are guaranteed with enough financing,personnel,facilities,and regulation;sup-ported by the unified information platform;general practitioners have been assigned the key role of health‘gatekeepers’;they provide primary care combined with basic public health services;there are integrated urban and rural health services and insurance coverage;and there is health care-pen-sion-nursing integration and general practitioner-contracted‘smart’services.Preliminary data collection and analysis indicate that the basic health status of Hangzhou residents is superior to that of residents of China as a whole,and some health indicators in Hangzhou are comparable to those in Western developed countries.Conclusion:It is reasonable to believe that the primary health care level in China,including Hangzhou,will be further developed and promoted with indexed performance evaluations and more effective implementation of additional measures.展开更多
文摘In 2009,China initiated a new round of health reform to establish a wellfunctioning health system.The 2009 health reform did make some significant achievements in improving affordability and accessibility.In particular,social health insurance has been expanded significantly and various social health insurance plans have covered over 95%of total population in China by 2011.The Chinese government also has significantly increased fiscal input for health financing.However,affordability remains a serious concern as the social health insurers,as purchasers,were not very effective in containing the growth of health expenditure.Accessibility to primary care and public health is another concern.In this context,health governance reforms are necessary to address affordability and accessibility issues.Health governance set rules for key actors of the health system(including service providers,health insurers and government departments)by taking into account the strategies and incentives of these actors in their interactions.In recent years,a series of reforms in health governance have been initiated.Some progresses have been achieved.For the next stage of health reform,issues including how to further reform the governance structure of medical institutions and how to improve resource allocation in the health system are critical.
文摘Objective:This study focuses on Hangzhou,a Chinese city with a population of nine million urban and rural residents,to examine the successful development and innovation experience of its primary health care service system during the new health reform in China since 2009 and then dis-seminate the findings through international third parties.Methods:Measures such as data analysis,study of documents and regulations,fieldwork,and expert discussions were used to systematically investigate primary health care in Hangzhou.The findings will have a profound practical impact on the health reform for nine million rural and urban residents throughout Hangzhou’s municipal boroughs.Results:Community health services in Hangzhou are characterized as follows:They are gov-ernment led;they are guaranteed with enough financing,personnel,facilities,and regulation;sup-ported by the unified information platform;general practitioners have been assigned the key role of health‘gatekeepers’;they provide primary care combined with basic public health services;there are integrated urban and rural health services and insurance coverage;and there is health care-pen-sion-nursing integration and general practitioner-contracted‘smart’services.Preliminary data collection and analysis indicate that the basic health status of Hangzhou residents is superior to that of residents of China as a whole,and some health indicators in Hangzhou are comparable to those in Western developed countries.Conclusion:It is reasonable to believe that the primary health care level in China,including Hangzhou,will be further developed and promoted with indexed performance evaluations and more effective implementation of additional measures.
