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Objectives: The purpose of this study is to summarize the historical experience of health financing in typical developed countries, in order to provide reference for China's health financing over the next 15 years.Methods: This paper uses hierarchical cluster analysis to determine the historical stage of typical developed countries similar to China in economic and social development from 2015 to 2030.Literature review is used to analyze the historical data and reform measures of health financing in typical developed countries during the similar stage.Results: The study found that the historical stage of typical developed countries that is similar to China in 2015-2030 is between the mid-or late-1970s and the beginning of the 21st century.During this period, the experience of health financing in typical developed countries mainly focused on controlling expenditures and costs, improving the health financing policy, strengthening the security system, etc.Conclusions: The similar stage research approach introduced in this paper provides a new idea and perspective to use the international experience for reference.Drawing lessons from the experience of health financing in typical developed countries combined with the Chinese context, this paper suggests the government should develop and improve diversified health financing channels, integrate and improve the health security system, and control the rapid escalation of health expenditure.
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Objective:Based on the perspective of Universal Health Coverage(UHC),a mathematical model was developed to conduct quantitative study on the development status of Basic Medical Insurance Schemes(BMIS) in China.Methods:A mixed model was developed to conduct quantitative study on the development of BMIS in the period of 2003-2015 from five dimensions:coverage of population,benefit package,reimbursement rate,risk pooling level and unity of the schemes.Sensitivity analysis was also performed.Results:The UHC scores for BMIS in China from 2003 to 2015 fluctuated obviously.Given the range of 0-100 percent,the UHC score in 2003 was 52.2％,28.5％ in 2006,23.9％ in 2010 and 26.5％ in 2015.The integration and equalization of BMIS and scaling up the risk pooling levels were shown to contribute significantly to UHC.Conclusion:The construction of mixed models was developed to provide a new calculation assessment tool for measuring the UHC,which consisted of completed evaluation tool package with addition model and multiplication model.Considering the future development of UHC,there is a still long way to go for BMIS in China.Emphases should be given to integration and equalization of BMIS as well as scaling up the risk polling to provincial and national level.
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This paper introduced the latest healthcare management and the service delivery system including health resources in Macao,highlighting the developed legal system,government financing policies for health sector,the well-developed medical service referral system,favorable development supports for private medical institutions,and remuneration incentive policies for health workers in Macao.These may serve as the useful implications and recommendations for health reform and development in mainland of China.
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Objective To analyze the optimal scales of secondary public hospitals so as to optimize the expansion of public hospitals.Methods Forty-six secondary public general hospitals in Beijing were selected as the sample,with input and output indicators pinpointed,for analysis of the status of economic return to scale of such hospitals from 1996 to 2012,and identification of inflexion points of the returns to scale.These efforts will help find an optimal scale of such hospitals.Resalts The period from 1996 to 2012 found the general effectiveness of such hospitals in a decline.In 2012,only 4 of the 46 hospitals were in DEA effectiveness status,and the other 42 hospitals were not; Forty-three inflexion points were identified.This study found that the strict control standards for secondary public general hospitals in Beijing were 298 beds and 585 staffs; the flexible control standards were 421 beds and 807 staffs.Conclclsion The optimal scales for secondary public hospitals were drown from the analysis,for references of other regions in China.The hospitals should prioritize resources efficiency instead of scale expansion.
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Objective To understand the issues in the conversion of private medical institutions and explore the possible options.Methods Case study and in-depth interview were employed in 6 converted medical institutions.Results The reasons for conversion were diversified,and the process was not standardized.The attitudes towards how to deal with the net assets differed so much among the executives.The legislation and supervision by the government were still under-developed.Conclusion The process for the conversion should be standardized and the ownership of the net assets should be clearly defined.The legislation and supervision on private medical institutions should be enhanced.
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Objective Perform a quantitative analysis on the development stage of Universal Health Coverage (UHC)in China and discuss key options for scaling up UHC in China.Methods Quantitative addition model was used to analyze the UHC trend in China from 2003-2011,along with a sensitivity analysis and international comparison with the UK.Results The quantitative analysis showed that the UHC in China,for the year of 2003,2008 and 2011 were 2.79,2.32 and 2.60 respectively.Sensitivity analysis showed the integration of the health insurance schemes and scaling up the risk pooling levels contributed more than other factors to UHC in China.Conclusion The UHC in China has been developed to the mid-stage,but still lags far behind developed countries like the UK.Such general measures as equalization of benefits and scaling up of the risk pooling level should be taken.First of all,equalization of medical benefits for both rural and urban residents makes the fundamental priority and policy in the pursuit of UHC in China.
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In the face of conversions of private medical institutions in the United States,the federal and state governments of the United States have developed corresponding laws and policies to adapt to the situation.The paper made an analysis of the profile and causes of the changed business nature of such institutions,and an introduction to the laws on which such change took place,the roles and responsibilities of government departments,the assets disposal and tax exemption status as well as the pricing policies.
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Public hospital reform pilots have been initiated recently and it is necessary to clarify some key issues. To this end, thispaper touches upon six fundamental issues, discussing the generality and value for the existence of public hospitals, differences between reforms of public hospital and those of state-owned enterprise, the public financing for and regulation on public hospitals, relationship with the private sector, as well as service and function positioning of public hospitals.
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This paper analyzed the social functions and roles played by public hospitals. Whatever the health system looks like National Health Services or Social Health Insurance, the functions of the public hospitals in society can be summarized as the following: Firstly, they are the providers of medical services with equal access by the residents. Secondly, they are the important components of the medical security system. Thirdly, they are the positive influencing forces in the medical market. Fourthly, they are the security forces for the nation and society. Fifthly, they are the incubator for training of human resources for health and lastly, they are also the developer of medical sciences. Hence, the existence and well-functioning of public hospitals are very crucial to meet the goal of universal coverage for basic health demands of the whole population.
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Objective of this study is to re-compute the national hospitalization rate in China using the second-hand data and explore the practical use of systematic review in health policy research field.Methods Domestic literatures on hospitalization rate in the last six years were collected and quality assessment was done.Merging analysis was used based upon systematic review approach.Results 25 reported literatures on hospitalization rate of urban and rural residents were included into the study.After merging analysis,the hospitalization rates were 4.70% for the country,5.31% for the urban and 4.26% for the rural.They are higher than the reported hospitalization rate in National Health Services Survey (NHSS)in 2003.After merging with the NHSS data,the hospitalization rate were 4.12%,4.85% and 3.82% respectively.Conclusions Systematic review can be applied in health service and policy research field.Data merging and information processing methods are diversified and could be selected upon research purpose and data attribute.Computation methods in systematic review in health policy research still need to be developed.
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In the evaluation of regional health planning as conducted in various parts of the country, there exist many possibilities with regard to the evaluation subject, evaluation content, evaluation model, and evaluation criteria. The paper analyzes these possibilities and their effect on the evaluation results and puts forward operational suggestions for such evaluation. With regard to the evaluation subject, the key role ought to be given to external evaluators, with internal evaluators playing an auxiliary role. With regard to the evaluation content, it is appropriate for the local governments or health administrative departments to conduct continuous plan evaluation and implementation evaluation, whereas policy evaluation ought to be conducted with the help of external evaluators such as academic societies. With regard to operability, it is proper for the local governments to conduct routine and periodic evaluations with fixed goals. The paper also discusses the realistic meanings embodied in various situations and solutions in case of a gap between the rational goals, planned goals and current index values in the evaluation of regional health planning. [
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Objective By analyzing the effect of adopting the responsibility system for entrusted asset management targets in some public hospitals the paper aims to explore the feasibility of doing so as to provide lessons for the reform of public hospitals in China. Methods Interviews of focus groups and surveys through questionnaires were conducted to find out about reform in the management of public hospitals in Wuxi City of Jiangsu Province, including successes and problems. Results Some problems remain to be solved while effects have been achieved in the entrusted management of public hospitals. Conclusion Reform of hospitals through entrusted management is currently a way of deepening the reform of public hospitals. Some preliminary conditions are already in place for reform in the system of public hospitals, yet support is stili needed in terms of sound policy and environment. In future reform should go a step further in personnel and distribution systems, supervised asset management, and the estabh'shment and perfection of the Corporation management structure. More efforts need to be made by the state in encouraging explorations and strengthening guidance.
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By analyzing the characteristics of the market for medical services, the paper discusses the role and functions of the government in the market for medical services, arguing that many problems in the delivery of medical services cannot be solved merely through the market mechanism. It also explores from the perspective of changing government functions ways to set up new relationships between the government and different types of hospitals.
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Objective To analyze and predict the market prospects for high-tech medical devices in China so as to provide the government, medical institutions and enterprises with decision-making information. Methods Such methods as literature review and policy analysis were employed to discuss the policies and market environment related to the allocation of medical devices. Results & Conclusion Factors affecting the allocation of high-tech medical devices have two kinds of functions, one of promotion and one of restriction. Future development of high-tech medical devices will depend on such factors as regulation and control of relevant policies and the force of thier implementation, the mecroscopic demand dynamics of medical institutions and the prices of the devices. Products by foreign manufacturers will continue to occupy and advantageous position on the high-end market while domestic manufacturers can also hope to increase their market shares in certain fields.
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Objective To estimate the fatality rate of SARS so as to provide data for the evaluation of patient care. Methods Based on the clinical features of the death cases of SARS, the average period between the time of clinical diagnosis and the time of death was determined and a method of estimation, which was lagged in time, was thus developed. Differences in the fatality rates of SARS across the world as well as the patterns of the differences were discussed using Chi-square and trend Chi-square tests. Results The fatality rate of SARS in Beijing, which presented a progressively downward tendency, was 7.2% by June 5, 2003, ranking relatively high among the SARS-hit zones in China. Conclusion Certain achievements have been attained in the clinical treatment of SARS cases, and yet more efforts need to be exerted. It is estimated that the eventual fatality rate of SARS in Beijing will be around 8%.