Publication:
Deepening Health Reform in China: Building High-Quality and Value-Based Service Delivery

Abstract
At a meeting in July 2014 in Beijing, we committed to working together on a flagship report that would help set the direction for health sector reform in China. This report, Deepening Health Reform in China, is the result. Using the successful model offered by previous flagship reports like China 2030 and Urban China, this report primarily offers a blueprint for a new direction for China’s health sector. The report’s main theme is the need for China to transition its healthcare delivery system toward people-centered, quality, integrated care built on the foundation of a strong primary healthcare system.
Link to Data Set
Citation
World Bank Group; World Health Organization; Ministry of Finance, P.R.C.; National Health and Family Planning Commission, P.R.C.; Ministry of Human Resources and Social Security, P.R.C.. 2016. Deepening Health Reform in China: Building High-Quality and Value-Based Service Delivery. © World Bank. http://hdl.handle.net/10986/24720 License: CC BY-NC-ND 3.0 IGO.
Digital Object Identifier
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Healthy China
    (Washington, DC: World Bank, 2019-03-28) World Bank; World Health Organization
    The report recommends that China maintain the goal and direction of its healthcare reform, and continue the shift from its current hospital-centric model that rewards volume and sales, to one that is centered on primary care, focused on improving the quality of basic health services, and delivers high-quality, cost-effective health services. With 20 commissioned background studies, more than 30 case studies, visits to 21 provinces in China, the report proposes practical, concrete steps toward a value-based integrated service model of healthcare financing and delivery, including: 1) Creating a new model of people-centered quality integrated health care that strengthens primary care as the core of the health system. This new care model is organized around the health needs of individuals and families and is integrated with higher level care and social services. 2) Continuously improve health care quality, establish an effective coordination mechanism, and actively engage all stakeholders and professional bodies to oversee improvements in quality and performance. 3) Empowering patients with knowledge and understanding of health services, so that there is more trust in the system and patients are actively engaged in their healthcare decisions. 4) Reforming public hospitals, so that they focus on complicated cases and delegate routine care to primary-care providers. 5) Changing incentives for providers, so they are rewarded for good patient health outcomes instead of the number of medical procedures used or drugs sold. 6) Boosting the status of the health workforce, especially primary-care providers, so they are better paid and supported to ensure a competent health workforce aligned with the new delivery system. 7) Allowing qualified private health providers to deliver cost-effective services and compete on a level playing field with the public sector, with the right regulatory oversight, and 8) Prioritizing public investments according to the burden of disease, where people live, and the kind of care people need on a daily basis.
  • Publication
    Angola : Public Expenditure Review, Volume 1. Policy Briefing
    (Washington, DC, 2007-12-20) World Bank; European Commission; Food and Agriculture Organization; United Nations Children’s Fund; United Nations Development Program; World Health Organization
    This report concerns about policy briefing and outlines the main findings and policy options associated with the analysis of public spending in terms of equity and allocative efficiency. This Public Expenditure Review (PER) covers the sectors of Education, Health, Agriculture, and the area of decentralization. The main objective of this Public Expenditure Review is to examine the allocative efficiency and equity of public spending in Angola. Five cross-cutting messages are drawn from the analysis of public spending and fiscal management in the context of this Public Expenditure Review: (i) the need to prepare public spending plans within a multiyear perspective; (ii) the need to improve the efficiency of public spending; (iii) the need to improve the quality of the data on social indicators and on the budget; (iv) the need to observe equity considerations in the preparation of the budget ; and (v) the need for steady progress with decentralization. The first volume, a policy briefing, outlines the main findings and policy options associated with the analysis of public spending in terms of equity and allocative efficiency. The second volume presents a fuller assessment of each sector and on decentralization
  • Publication
    Lessons for Hospital Autonomy
    (World Bank, Washington, DC, 2011-07) Vietnam Ministry of Health; Health Strategy and Policy Institute; World Bank; World Health Organization
    The Government of Vietnam sees hospital autonomy policy as important and consistent with current development trends in Vietnam. It is based on government policies as laid out in government Decree on financial autonomy of revenue-generating public service entities; and to 2006, it is replaced by decree on professional, organizational, human resource management and financial autonomy of revenue-generating and state budget-financed public service entities. These policies apply to public service entities in all sectors, including the health sector and hospitals. This policy is an important element of public administration reform in Vietnam, helping service entities survive and develop under the socialist-oriented market mechanism. It aims to help hospitals in fulfilling assigned professional tasks by allowing them to restructure their organization and staffing. The government has also allowed public service entities to mobilize private capital and joint ventures to organize activities and services responding to social and people's needs. This study will show that since the implementation of decrees, a number of improvements have been demonstrated within hospitals with respect to physical facilities, service provision, medical techniques, service quality and staff incomes, thus creating stability and satisfaction among hospital workers. But it also describes the international evidence that implementation of hospital autonomy comes with a risk of unintended outcomes driven by powerful financial incentives from the market place to increase revenue. These include supply induced demand, cost escalation, inappropriate care. There are some indications that such risks may be emerging in Vietnam as well, although these would need further research. Fortunately, there is also international evidence about policies that can mitigate such risks, and these are also described in this report. This report will inspire further studies and encourage policymakers to think about continuous improvement of policies.
  • Publication
    Assessment of Systems for Paying Health Care Providers in Mongolia
    (World Bank, Washington, DC, 2015) Joint Learning Network; Mongolia Ministry of Health; World Bank; World Health Organization
    Achieving access to basic health services for the entire population without risk of financial hardship or impoverishment from out-of-pocket expenditures (‘universal health coverage’ or UHC) is a challenge that continues to confront most low- and middle-income countries. As coverage expands in these countries, issues of financial sustainability, efficiency, and quality of care quickly rise to the surface. Strategic health purchasing is an important lever to efficiently manage funds for UHC through the definition of what is purchased (which services and benefits the covered population is entitled to receive), from whom services are purchase (which providers are contracted to deliver the covered services), and how and how much the providers are paid. The assessment was conducted to help inform the design and implementation of Mongolia’s provider payment systems going forward. Health care provider payment systems, the way providers are paid to deliver the covered package of services, are an important part of strategic purchasing to balance system revenues and costs in a way that creates incentives for providers to improve quality and deliver services more efficiently. This ultimately makes it possible to expand coverage within limited funds (Langenbrunner, Cashin and ODougherty 2009). In practice, however, provider payment systems are often under-utilized as an effective tool to achieve UHC goals. After providing a brief overview of Mongolia’s health financing and service delivery system, this report describes the provider payment assessment and summarizes the main findings. It discusses the positive aspects and shortcomings of the current mix of payment systems and compares the design and implementation with international good practices. The chapter concludes by providing a roadmap for refining and realigning Mongolia’s provider payment system going forward.
  • Publication
    Angola : Public Expenditure Review, Volume 2. Sectoral Review
    (Washington, DC, 2007-12-20) World Bank; European Commission; Food and Agriculture Organization; United Nations Children’s Fund; United Nations Development Program; World Health Organization
    This report concerns about policy briefing and outlines the main findings and policy options associated with the analysis of public spending in terms of equity and allocative efficiency. This Public Expenditure Review (PER) covers the sectors of Education, Health, Agriculture, and the area of decentralization. The main objective of this Public Expenditure Review is to examine the allocative efficiency and equity of public spending in Angola. Five cross-cutting messages are drawn from the analysis of public spending and fiscal management in the context of this Public Expenditure Review: (i) the need to prepare public spending plans within a multiyear perspective; (ii) the need to improve the efficiency of public spending; (iii) the need to improve the quality of the data on social indicators and on the budget; (iv) the need to observe equity considerations in the preparation of the budget ; and (v) the need for steady progress with decentralization. The first volume, a policy briefing, outlines the main findings and policy options associated with the analysis of public spending in terms of equity and allocative efficiency. The second volume presents a fuller assessment of each sector and on decentralization

Users also downloaded

Showing related downloaded files

  • Publication
    Vietnam
    (World Bank, Hanoi, 2020-05-01) World Bank
    Following from Vietnam’s ratification of the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) in late 2018 and its effectiveness from January 2019, and the European Parliament’s recent approval of the European Union-Vietnam Free Trade Agreement (EVFTA) and its subsequent planned ratification by the National Assembly in May 2020, Vietnam has further demonstrated its determination to be a modern, competitive, open economy. As the COVID-19 (Coronavirus) crisis has clearly shown, diversified markets and supply chains will be key in the future global context to managing the risk of disruptions in trade and in supply chains due to changing trade relationships, climate change, natural disasters, and disease outbreaks. In those regards, Vietnam is in a stronger position than most countries in the region. The benefits of globalization are increasingly being debated and questioned. However, in the case of Vietnam, the benefits have been clear in terms of high and consistent economic growth and a large reduction in poverty levels. As Vietnam moves to ratify and implement a new generation of free trade agreements (FTAs), such as the CPTPP and EVFTA, it is important to clearly demonstrate, in a transparent manner, the economic gains and distributional impacts (such as sectoral and poverty) from joining these FTAs. In the meantime, it is crucial to highlight the legal gaps that must be addressed to ensure that national laws and regulations are in compliance with Vietnam’s obligations under these FTAs. Readiness to implement this new generation of FTAs at both the national and subnational level is important to ensure that the country maximizes the full economic benefits in terms of trade and investment. This report explores the issues of globalization and the integration of Vietnam into the global economy, particularly through implementation of the EVFTA.
  • Publication
    Jobs in a Changing Climate: Insights from World Bank Group Country Climate and Development Reports Covering 93 Economies
    (Washington, DC: World Bank, 2025-11-05) World Bank
    The World Bank Group’s Country Climate and Development Reports (CCDRs) provide a crosscutting look at how countries’ development prospects, and the job opportunities they offer to their people, can be threatened by climate impacts and supported by climate policies. Climate change and policies affect jobs through impacts on productivity, energy and material efficiency, and physical, human, and natural capital. They can also transform employment opportunities, especially through complementary measures that help workers and firms adapt to and benefit from new technologies and production practices. Prepared by the World Bank, the International Finance Corporation (IFC), and the Multilateral Investment Guarantee Agency (MIGA), CCDRs integrate country perspectives, climate science and economic modeling, private sector information, and policy analysis to assess how countries can successfully grow and develop their economies and create jobs despite increasing climate risks and while achieving their climate objectives and commitments. Each CCDR starts from the country’s development priorities, opportunities, and challenges, and is developed in close consultation with governments, businesses, and civil society, ensuring the recommendations reflect national priorities. By combining evidence on adaptation, resilience, and emissions pathways, CCDRs highlight where climate action can reinforce development and job creation, and where targeted policies are needed to manage risks and smooth labor market transitions. Taken together, these elements can help create local jobs, ensure economic transitions are just and inclusive, and equip workers and firms to navigate the disruptions and opportunities of a changing climate and changing technologies.
  • Publication
    World Development Report 2024
    (Washington, DC: World Bank, 2024-08-01) World Bank
    Middle-income countries are in a race against time. Many of them have done well since the 1990s to escape low-income levels and eradicate extreme poverty, leading to the perception that the last three decades have been great for development. But the ambition of the more than 100 economies with incomes per capita between US$1,100 and US$14,000 is to reach high-income status within the next generation. When assessed against this goal, their record is discouraging. Since the 1970s, income per capita in the median middle-income country has stagnated at less than a tenth of the US level. With aging populations, growing protectionism, and escalating pressures to speed up the energy transition, today’s middle-income economies face ever more daunting odds. To become advanced economies despite the growing headwinds, they will have to make miracles. Drawing on the development experience and advances in economic analysis since the 1950s, World Development Report 2024 identifies pathways for developing economies to avoid the “middle-income trap.” It points to the need for not one but two transitions for those at the middle-income level: the first from investment to infusion and the second from infusion to innovation. Governments in lower-middle-income countries must drop the habit of repeating the same investment-driven strategies and work instead to infuse modern technologies and successful business processes from around the world into their economies. This requires reshaping large swaths of those economies into globally competitive suppliers of goods and services. Upper-middle-income countries that have mastered infusion can accelerate the shift to innovation—not just borrowing ideas from the global frontiers of technology but also beginning to push the frontiers outward. This requires restructuring enterprise, work, and energy use once again, with an even greater emphasis on economic freedom, social mobility, and political contestability. Neither transition is automatic. The handful of economies that made speedy transitions from middle- to high-income status have encouraged enterprise by disciplining powerful incumbents, developed talent by rewarding merit, and capitalized on crises to alter policies and institutions that no longer suit the purposes they were once designed to serve. Today’s middle-income countries will have to do the same.
  • Publication
    Kyrgyz Republic Country Climate and Development Report
    (Washington, DC: World Bank, 2025-11-03) World Bank Group
    This Country Climate and Development Report (CCDR) on the Kyrgyz Republic aims to support the country’s development goals amid a changing climate. The CCDR considers two policy scenarios up to 2050: the business-as-usual (BAU) and high-growth scenarios. As it quantifies the likely impacts of climate change on the Kyrgyz economy between now and 2050, the report highlights key government actions to best prepare for and adapt to climate impacts (referred to as “with adaptation” measures), with a particular focus on the time horizon up to 2030. The CCDR also outlines a path to net zero emissions by 2050 (referred to as “with mitigation” measures, “decarbonization,” or, simply, “net zero 2050”), highlighting associated development co-benefits.
  • Publication
    Doing Business 2009 : Comparing Regulation in 181 Economies
    (Washington, DC : World Bank and Palgave Macmillon, 2008) International Finance Corporation; World Bank
    Doing Business 2009 is the sixth in a series of annual reports investigating the regulations that enhance business activity and those that constrain it. Doing Business presents quantitative indicators on business regulations and the protection of property rights that can be compared across 181 economies from Afghanistan to Zimbabwe and over time. Regulations affecting 10 stages of the life of a business are measured: starting a business, dealing with construction permits, employing workers, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts, and closing a business. Data in Doing Business 2009 are current as of June 1, 2008. The indicators are used to analyze economic outcomes and identify what reforms have worked, where, and why. The methodology for the legal rights of lenders and borrowers, part of the getting credit indicators, changed for Doing Business 2009. The paper includes the following headings: overview, starting a business, dealing with construction permits, employing workers, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts, and closing a business.