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Enhancing community system in China's recent health reform: An effort to improve equity in essential health care

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  • Li, Hua
  • Yu, Wei

Abstract

Objects This article reviews China's policy development on community health centers and examines effects on service selection, due to difference in funding level and profit seeking incentive.Methods We summarize policies on community health centers since 1997 and identify the importance of joint action from seven government agencies in 2006. Using survey data in 2006 and 2007 from two cities with different financing capability and management strategy, we analyze service selection between these cities and before and after a funding policy change.Results With better financing capability (65 vs. 9 Yuan per resident) and a government backup for any loss, community centers in city A provide more high-cost services than city B such as house visits (275 vs. 6 per 10,000 residents) and house beds (52 vs. 1 per 10,000 residents). Both services are mostly demanded by residents.Conclusion Joint action from related government agencies in 2006 is critical for the rapid development of community health system in China. With less funding, community centers have to restrict high-cost services. There is no evidence of shirking after initiating a fully funded financing policy. Economic disparity among cities is a major barrier for improving equity in basic health care.

Suggested Citation

  • Li, Hua & Yu, Wei, 2011. "Enhancing community system in China's recent health reform: An effort to improve equity in essential health care," Health Policy, Elsevier, vol. 99(2), pages 167-173, February.
    • Handle: RePEc:eee:hepoli:v:99:y:2011:i:2:p:167-173
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    Cited by:

    1. Jia, Peng & Wang, Youfa & Yang, Min & Wang, Limin & Yang, Xuchao & Shi, Xinyu & Yang, Lijian & Wen, Jin & Liu, Yi & Yang, Maokang & Xin, Junguo & Zhang, Fengying & Jiang, Lihua & Chi, Chunhua & Zhang,, 2022. "Inequalities of spatial primary healthcare accessibility in China," Social Science & Medicine, Elsevier, vol. 314(C).
    2. Xinyu Zhang & Lin Zhao & Zhuang Cui & Yaogang Wang, 2015. "Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-15, December.
    3. Yue Zhou & Haishaerjiang Wushouer & Daniel Vuillermin & Xiaodong Guan & Luwen Shi, 2021. "Does the universal medical insurance system reduce catastrophic health expenditure among middle-aged and elderly households in China? A longitudinal analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 463-471, April.
    4. Changmin Tang & Chaojie Liu & Pengqian Fang & Yuanxi Xiang & Rui Min, 2019. "Work-Related Accumulated Fatigue among Doctors in Tertiary Hospitals: A Cross-Sectional Survey in Six Provinces of China," IJERPH, MDPI, vol. 16(17), pages 1-13, August.
    5. Ying Chen & Jiale Wu, 2022. "The Effect of the Referral System on the Accessibility of Healthcare Services: A Case Study of the Wuhan Metropolitan Development Zone," IJERPH, MDPI, vol. 19(16), pages 1-14, August.

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