Practice and implications of the medical insurance payment system reform: Exploration based on Health XI Project / 中国卫生政策研究

Medical insurance payment reform is an important part of healthcare reform in China. Based on the practice and research of China Rural Health Project ( hereinafter referred asHealth XI Project) financed by World Bank (WB) and UK Department for International Development (DFID) implemented in 40 counties of 8 Chinese provinces between 2009 and 2014 , this thesis analyses the principle and feasible policy route of medical payment re-form for the country, by ways of reviewing the policy evolution, and summarizing the process of project pilot from sin-gle mode of payment-a simple mixed payment-to the comprehensive payment system reform and analyzing the advanta-ges and disadvantages of medical insurance payment methods.

Management and control of hypertension and diabetes in rural areas of China: Based on the practice of China Rural Health Project / 中国卫生政策研究

With the support of World Bank ( WB ) and UK Department for International Development ( DFID) , China Rural Health Project ( hereinafter referred asHealth XI Project) has successfully covered 40 coun-ties in 8 provinces. With the establishment of community diagnosis and health records as the entry point, hyperten-sion, diabetes and other major chronic diseases as the starting point, and focus on the needs of healthy people, high-risk groups and patients, the project mainly adopts health education and promotion, health management, disease management and other measures to explore the establishment of a new model of rural chronic disease management. By analyzing the monitoring data of chronic diseases in the project zones, this study found that the number of registered and managed patients with hypertension and diabetes increased significantly, from 397,113 and 136,326 in 2009 to 1,500,252 and 388,846 in 2013, respectively. The management rate also increased from 60. 8% and 32. 2% in 2009 to 92. 2% and 88. 8% in 2013, respectively. The results of the 5th National Health Service Survey show that, the control rates for self-reported hypertension and diabetes ((53. 8% and 50. 2%, respectively) in the project zones were significantly higher than the national average in rural areas ( 54 . 9% and 38 . 3%, respectively ) . This paper suggests that, with focus on training, health education, health promotion, health management and disease manage-ment as the core mainline, the chronic disease management model has effectively improved the chronic disease service capabilities in rural areas,. The comprehensive and integrated chronic disease interventions implemented by the pro-ject in the rural areas is practical, and it has value of popularization and application.