Publication:
Healthy China: Deepening Health Reform in China

Loading...
Thumbnail Image
Files in English
English PDF (5.32 MB)
15,704 downloads
Other Files
Chinese PDF (7.02 MB)
7,141 downloads
Date
2019-03-28
ISSN
Published
2019-03-28
Editor(s)
Abstract
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.
Link to Data Set
Citation
World Bank; World Health Organization. 2019. Healthy China: Deepening Health Reform in China. © World Bank and World Health Organization. http://hdl.handle.net/10986/31458 License: CC BY 3.0 IGO.
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
    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
    The Path to Integrated Insurance Systems in China
    (Washington, DC, 2010-06) World Bank
    Since the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, health care in China has become a leading national concern. Often highlighted by the popular phrase, kan-bing-nan, kan-bing-gui (seeking care is difficult and expensive), healthcare costs can be devastating. Prior to 2007, there were two formal insurance programs: the Urban Employee Basic Medical Insurance (UEBMI) for the urban employed population, and the New Rural Cooperative Medical Insurance (NRCMI) for rural residents. A third major group-urban resident without formal employment-was essentially left out of the state health security system. In July 2007, the State Council initiated a pilot experiment in 79 cities-the Urban Resident Basic Medical Insurance (URBMI). The plan targeted urban residents without formal employment, especially the elderly and children (State Council 2007). The present health policy note provides an updated review of healthcare settings and policy reforms, focusing primarily on urban health financing. It discusses urban insurance in the context of universal coverage and how to harmonize insurance schemes across urban and rural areas. This discussion is placed in the context of global experience and emerging principles of best practices.
  • Publication
    Deepening Health Reform in China
    (Washington, DC: World Bank, 2016-07-22) 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.
    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.
  • Publication
    Toward a Healthy and Harmonious Life in China
    (Washington, DC, 2011) World Bank
    China's 12th five-year plan (2011-2015) aims to promote inclusive, equitable growth and development by placing an increased emphasis on human development. Good health is an important component of human development, not only because it makes people's lives better, but also because having a healthy and long life enhances their ability to learn, acquire skills, and contributes to society. Indeed, good health is a fundamental right of every human being. Good health among a population can also enhance economic performance by improving labor productivity and reducing economic losses that arise from illnesses. The findings and recommendations can inform and promote a broad dialogue toward the development of a multisectoral response to effectively address the growing burden of Non Communicable Diseases (NCDs), including a better alignment of the health system with the population's health needs. The report also advocates implementing 'health in all' policies and actions for a multisectoral response to NCDs in China to help achieve the ultimate goal of 'harmonious' development and growth.
  • Publication
    Healthy Development : The World Bank Strategy for Health, Nutrition, and Population Results
    (Washington, DC, 2007) World Bank
    This paper updates the 1997 World Bank Health, Nutrition, and Population Strategy to enhance Bank capacity so that it continues to contribute to this virtuous circle in light of the momentous changes of the past decade in the architecture of development assistance for health (DAH) and of persisting HNP challenges worldwide. This 2007 HNP Strategy outlines the Bank vision for improving its own capacity to respond globally and with a country focus to the urgent issues posed by these changes and challenges.

Users also downloaded

Showing related downloaded files

  • Publication
    Two Dragon Heads : Contrasting Development Paths for Beijing and Shanghai
    (World Bank, 2010) Yusuf, Shahid; Nabeshima, Kaoru
    In broad terms, the sources of economic growth are well understood, but relatively few countries have succeeded in effectively harnessing this knowledge for policy purposes so as to sustain high rates of growth over an extended period of time. Among the ones that have done so, China stands out. Its gross domestic product (GDP) growth rate, which averaged almost 10 percent between 1978 and 2008, is unmatched. Even more remarkable is the performance of China's three leading industrial regions: the Bohai region, the Pearl River Delta, and the Yangtze River (Changjiang) delta area. These regions have averaged growth rates well above 11 percent since 1985. Shanghai is the urban axis of the Yangtze River Delta's thriving economy; Beijing is the hinge of the Bohai region. Their performance and that of a handful of other urban regions will determine China's economic fortunes and innovativeness in the coming decades. The balance of this volume is divided into five chapters. Chapter two encapsulates the sources of China's growth and the current and future role of urban regions in China. The case for the continuing substantial presence of manufacturing industry for growth and innovation in the two urban centers is made in chapter three. Chapter four briefly examines the economic transformation of four global cities and distills stylized trends that can inform future development in Beijing and Shanghai. Chapter five describes the industrial structure of the two cities, identifies promising industrial areas, and analyzes the resource base that would underpin growth fueled by innovation. Finally, chapter six suggests how strategy could be reoriented on the basis of the lessons delineated in chapter four and the economic capabilities presented in chapter five.
  • Publication
    Impact Evaluation in Practice, First Edition
    (World Bank, 2011) Gertler, Paul J.; Martinez, Sebastian; Premand, Patrick; Rawlings, Laura B.; Vermeersch, Christel M. J.
    The Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policymakers and development practitioners. The book incorporates real-world examples to present practical guidelines for designing and implementing evaluations. Readers will gain an understanding of the uses of impact evaluation and the best ways to use evaluations to design policies and programs that are based on evidence of what works most effectively. The handbook is divided into three sections: Part One discusses what to evaluate and why; Part Two outlines the theoretical underpinnings of impact evaluation; and Part Three examines how to implement an evaluation. Case studies illustrate different methods for carrying out impact evaluations.
  • Publication
    Empowerment in Practice : From Analysis to Implementation
    (Washington, DC: World Bank, 2006) Alsop, Ruth; Bertelsen, Mette; Holland, Jeremy
    This book represents an effort to present an easily accessible framework to readers, especially those for whom empowerment remains a puzzling development concern, conceptually and in application. The book is divided into two parts. Part 1 explains how the empowerment framework can be used for understanding, measuring, monitoring, and operationalizing empowerment policy and practice. Part 2 presents summaries of each of the five country studies, using them to discuss how the empowerment framework can be applied in very different country and sector contexts and what lessons can be learned from these test cases. While this book can offer only a limited empirical basis for the positive association between empowerment and development outcomes, it does add to the body of work supporting the existence of such a relationship. Perhaps more importantly, it also provides a framework for future research to test the association and to prioritize practical interventions seeking to empower individuals and groups.
  • Publication
    China 2030 : Building a Modern, Harmonious, and Creative High-Income Society [pre-publication version]
    (Washington, DC: World Bank, 2012-02-27) World Bank; Development Research Center of the State Council, P.R.C.
    China should complete its transition to a market economy--through enterprise, land, labor, and financial sector reforms--strengthen its private sector, open its markets to greater competition and innovation, and ensure equality of opportunity to help achieve its goal of a new structure for economic growth. These are some of the key findings of a joint research report by a team from the World Bank and the Development Research Center of China’s State Council, which lays out the case for a new development strategy for China to rebalance the role of government and market, private sector and society, to reach the goal of a high income country by 2030.   This report recommends steps to deal with the  risks facing China over the next 20 years, including the risk of a hard landing in the short term, as well as challenges posed by an ageing and shrinking workforce, rising inequality, environmental stresses, and external imbalances. The report lays out six strategic directions for China’s future: * Completing the transition to a market economy; * Accelerating the pace of open innovation; * Going “green” to transform environmental stresses into green growth as a driver for development; * Expanding opportunities and services such as health, education and access to jobs for all people; * Modernizing and strengthening its domestic fiscal system; * Seeking mutually beneficial relations with the world by connecting China’s structural reforms to the changing international economy.
  • Publication
    World Development Report 2004
    (World Bank, 2003) World Bank
    Too often, services fail poor people in access, in quality, and in affordability. But the fact that there are striking examples where basic services such as water, sanitation, health, education, and electricity do work for poor people means that governments and citizens can do a better job of providing them. Learning from success and understanding the sources of failure, this year’s World Development Report, argues that services can be improved by putting poor people at the center of service provision. How? By enabling the poor to monitor and discipline service providers, by amplifying their voice in policymaking, and by strengthening the incentives for providers to serve the poor. Freedom from illness and freedom from illiteracy are two of the most important ways poor people can escape from poverty. To achieve these goals, economic growth and financial resources are of course necessary, but they are not enough. The World Development Report provides a practical framework for making the services that contribute to human development work for poor people. With this framework, citizens, governments, and donors can take action and accelerate progress toward the common objective of poverty reduction, as specified in the Millennium Development Goals.