Reforming China's rural health system

'Reforming China's Rural Health System' examines the performance and workings of China's rural health system leading up to the reforms of the 2000s, outlines the reforms, and presents some early evidence on their impacts. The authors outline ideas for building on these reforms to...

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Hlavní autoři:	Wagstaff, Adam, World Bank
Médium:	E-kniha Kniha Publikace
Jazyk:	angličtina
Vydáno:	Washington, D.C World Bank 2009 World Bank Publications The World Bank
Vydání:	1
Edice:	Directions In Development - Human Development
Témata:	Access to health care ADVERSE SELECTION AGRICULTURAL POPULATION BABY BEDS CAPITAL SPENDING CENTER FOR HEALTH CESAREAN SECTIONS CHILD DEATH CHILD HEALTH CHILD MORTALITY CHILD MORTALITY RATES China CHINESE POPULATION CITIES CITIZENS CLINICAL SERVICES CLINICS COMMUNITY HEALTH COMPLICATIONS COST OF CARE COST-EFFECTIVENESS DEATH RATE DEATHS DELIVERY OF HEALTH CARE Delivery of Health Care > China DELIVERY SYSTEM DIABETES DISEASE CONTROL DISSEMINATION DOCTORS DRUGS ECONOMIC GROWTH ECONOMIC PROGRESS ECONOMIC TRANSITION ENVIRONMENTAL POLLUTION EPIDEMIC EPIDEMIOLOGICAL TRANSITION EVALUATION TECHNIQUES EXPENDITURES FAMILIES FAMILY MEMBERS FAMILY PLANNING FEE-FOR-SERVICE FINANCIAL CONSEQUENCES FINANCIAL IMPACT FINANCIAL INCENTIVES Gesundheitsreform GROSS DOMESTIC PRODUCT HEALTH CARE HEALTH CARE COSTS HEALTH CARE DELIVERY HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CARE REFORM Health care reform > China HEALTH CARE SYSTEM HEALTH CENTERS HEALTH DATA HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH FACILITIES HEALTH FINANCE HEALTH FINANCING HEALTH FINANCING SYSTEM HEALTH INDICATORS HEALTH INEQUALITIES HEALTH INFRASTRUCTURES HEALTH INSTITUTIONS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURERS HEALTH INTERVENTIONS HEALTH ORGANIZATION HEALTH OUTCOMES Health policy HEALTH PROBLEMS HEALTH PROGRAMS HEALTH PROVIDERS HEALTH PROVISION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTH WORKERS HEPATITIS B HIV HIV/AIDS HOSPITAL HOSPITAL CARE HOSPITALIZATION HOSPITALS HOUSEHOLD EXPENDITURE HOUSEHOLD INCOME HUMAN DEVELOPMENT HUMAN IMMUNODEFICIENCY VIRUS HUMAN RESOURCES HYGIENE HYPERTENSION ILLNESS IMMUNIZATION IMMUNIZATIONS IMMUNODEFICIENCY IMPORTANT POLICY INCOME INCOME COUNTRIES INDIVIDUAL HOUSEHOLDS INDUCED DEMAND INDUSTRIALIZATION INFANT INFANT DEATHS INFANT MORTALITY INFANT MORTALITY RATE INFECTIOUS DISEASES INPATIENT CARE INSURANCE INSURANCE COVERAGE INSURANCE PACKAGE INSURANCE SCHEMES INSURANCE SYSTEMS Insurance, Health > China INTEGRATION INTERVENTION LACK OF HEALTH INSURANCE LEGAL STATUS LIVE BIRTHS LIVING STANDARDS LOCAL GOVERNMENTS Ländliches Gesundheitswesen MALARIA MALARIA CONTROL MANDATES MARKET ECONOMY MATERNAL DEATHS MATERNAL MORTALITY MATERNAL MORTALITY RATE MATERNAL MORTALITY RATIO MEASLES MEDICAL MEDICAL BILLS MEDICAL CARE MEDICAL COSTS MEDICAL INSURANCE MEDICAL NEEDS MEDICAL SAVINGS ACCOUNTS MEDICAL SERVICES MEDICAL SYSTEM MEDICAL TECHNOLOGY MEDICAL TRAINING MEDICINES MIGRANT MIGRANT WORKERS MILLENNIUM DEVELOPMENT GOAL MINISTRIES OF HEALTH MINISTRY OF HEALTH MORTALITY MORTALITY LEVELS MORTALITY REDUCTION MOTHER NATIONAL DEVELOPMENT NATIONAL HEALTH NATIONAL LEVEL NATIONAL POLICY NEWBORN NUMBER OF DEATHS NUMBER OF PEOPLE NUTRITION OBESITY OUTPATIENT CARE PATIENT PATIENTS PERSONAL HEALTH PHARMACEUTICAL EXPENDITURE PHARMACEUTICAL SPENDING PHYSICAL ACTIVITY POCKET PAYMENTS POLICY MAKERS POLIO POLLUTION POVERTY REDUCTION PRACTITIONERS PREVENTABLE DISEASES PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROGRESS PROVIDER INCENTIVES PROVIDER PAYMENT PROVINCIAL HOSPITALS PUBLIC HEALTH PUBLIC HEALTH INTERVENTIONS PUBLIC HEALTH PROGRAMS PUBLIC HEALTH SERVICES PUBLIC HEALTH SPENDING PUBLIC HEALTH SYSTEM PUBLIC SECTOR PUBLIC SERVICES PURCHASING POWER PURCHASING POWER PARITY QUALITY CARE QUALITY OF CARE QUARANTINE Reform REGIONAL POLICY RISK FACTORS RURAL AREAS Rural health services Rural health services > China RURAL POPULATION RURAL RESIDENTS SAFETY NET SMOKING SOCIAL HEALTH INSURANCE SOCIAL PROGRESS SOCIAL SECTOR SOCIAL SECTORS SOCIAL SECURITY TB CONTROL TECHNICAL ASSISTANCE TETANUS TUBERCULOSIS TUBERCULOSIS CONTROL UNDER-FIVE MORTALITY URBAN AREAS URBAN POPULATION VULNERABLE GROUPS WORKERS WORLD HEALTH ORGANIZATION Asia East Asia MORTALITY PUBLIC HEALTH INFECTIOUS DISEASES PATIENTS HYGIENE WORKERS MEDICINES HEPATITIS B IMMUNIZATION FAMILY PLANNING HEALTH CARE HEALTH SERVICES COMMUNITY HEALTH HEALTH INTERVENTIONS NUTRITION PRIMARY HEALTH CARE INTERVENTION IMMUNODEFICIENCY HEALTH OUTCOMES POLIO
ISBN:	9780821379820, 0821379828, 9780821379837, 0821379836
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Intro -- Contents -- Foreword -- Acknowledgments -- Abbreviations -- Chapter 1 Introduction -- China's Shift from Economic Growth to "Balanced Development -- The World Bank's Analytic and Advisory Activities on China's Rural Health Sector -- Overview of the Book -- Chapter 2 China's Health Challenges at the Start of the New Millennium -- Trends in Health Outcomes -- Trends in Health Inequalities -- Out-of-Pocket Costs-A Barrier to Care and a Cause of Poverty -- Accounting for the Household Burden -- Provider Incentives, Costs, and the Quality of Care -- Health Insurance Contraction -- Inequality in Government Spending -- Challenges and Reforms-Creating a Path Forward -- Chapter 3 The Rural Health Reforms of the 2000s -- The New Rural Cooperative Medical Scheme -- Medical Assistance -- Public Health -- Provider Payment Reform -- Other Reforms in Service Delivery -- Sizing Up the Recent Reforms -- Annex: Impact Evaluation of NRCMS -- Chapter 4 Looking Toward a New Decade: The Big Picture -- Health Systems-Goals, Functions, and Actors -- Evolving Ideas and International Best Practice -- Reform over the Medium Term -- Reform over the Longer Term -- Chapter 5 Financing Rural Insurance Coverage -- More Resources for NRCMS -- Converting NRCMS into a "Purchaser -- What Should Be Covered? -- Strengthening Management and Governance -- Priorities and Sequencing -- Chapter 6 Improving Service Delivery: A Question of Incentives -- Changing Provider Incentives -- Enabling Providers to Respond to New Incentives -- Reform Priorities, Sequencing, and Capacity -- Chapter 7 Enhancing Accountability and Incentives in Public Health -- The Misalignment of Incentives and Accountability -- Geographic Disparities in Spending -- Roles and Responsibilities across Levels of Government -- Clarifying Responsibilities and Financial Incentives at the County Level
7.8 Service Overlap across Institutions with Public Health Responsibilities -- 7.9 Financing Sources for Prevention and Public Health -- 7.10 Where Do Out-of-Pocket Expenditures on Prevention and Public Health Go? -- 8.1 Financial Flows in the Proposed System -- 8.2 Current (2004) and Possible Financing Mixes -- Tables -- A3.1 Estimates of NRCMS Impact on Households -- A3.2 Estimates of NRCMS Impact on Facilities -- 5.1 Proposed Financial, Purchasing, and Delivery Responsibilities by Intervention Type -- 7.1 Key Weaknesses in the Public Health System
Priorities, Sequencing, Political Economy, and Skills -- Annex: Case Study of Public Health Financing and Organization in Two Counties -- Chapter 8 The Longer-Term Reform Agenda -- Limitations of the Emerging Health Insurance Model -- A Dual Agenda for Financing Long-Term Reform -- Getting from Here to There -- Chapter 9 Conclusions -- Notes -- References -- Index -- Boxes -- 3.1 NRCMS circa 2005 -- 3.2 Medical Assistance circa 2005 -- 3.3 Challenges in Estimating Public Health Spending and Comparing across Countries -- 3.4 Provider Payment Reforms in Urban China -- 3.5 Prospective Payments and Purchasing in NRCMS -- 3.6 Impacts of Treatment Protocols, Drug Lists, and Other Innovations in the Health VIII Project in Gansu Province -- 5.1 Trends in Financing Health in Rural China -- 5.2 The Benefit Package in Mexico's Popular Health Insurance Program -- 5.3 Medical Savings Accounts in China and Singapore -- 5.4 Merging of NRCMS and BMI -- 5.5 Health Insurance Governance in Estonia and Costa Rica -- 6.1 Price Regulation in China -- 6.2 International Experience with Provider Payment Reforms -- 6.3 The Importance of Inpatient Care for NRCMS -- 6.4 Setting Health Sector Prices in Japan -- 6.5 Approaches to Extra Billing -- 6.6 Impact of Ownership and Profit Status on Performance in China and Abroad -- 6.7 Governance of Autonomous Public Sector Providers -- 6.8 Issues in the Legislation and Regulation of Nonprofit Organizations -- 7.1 What Is Public Health? -- 7.2 The Case for (and against) Decentralization -- 7.3 Changing Patterns of Intergovernmental Relations in China -- 7.4 Cost-Effectiveness and the Challenge of Prioritization -- 7.5 Public Health in a Decentralized Context: How Do Other Countries Do It? -- 7.6 The Challenge of Intersectoral Public Health Coordination -- Figures -- 1.1 Declining Poverty and Rising Living Standards, 1980-2007
1.2 China-to-OECD Mortality Ratios, 1980-2005 -- 2.1 Under-Five Mortality in China, Indonesia, and Malaysia, 1970s-90s -- 2.2 Communicable Disease Mortality in China -- 2.3 Inequalities in Child and Maternal Mortality in China, 2003 -- 2.4 Household Cost of Hospital Care in China and Other Countries -- 2.5 Out-of-Pocket Health Spending in China, 1990-2000 -- 2.6 Inpatient Care Costs in China and Other Countries -- 2.7 Hospital Efficiency in China and OECD Countries -- 2.8 Technology Adoption in China and Other Countries -- 2.9 Rising Cost of Hospital Care in China, 2003-05 -- 2.10 Insurance Coverage, 1993-2003 -- 2.11 Impact of Government Health Spending on the Poor and Better Off -- 2.12 Government Health Expenditure by Provincial Wealth and Need -- 3.1 Government Public Health, Total Health, and Total Spending, 1990-2003 -- 3.2 Government Subsidies and Business Fees as Income Sources for Public Health Institutions -- 3.3 Government Spending on Prevention and Public Health in China and Other Countries -- 3.4 Government Spending on Prevention and Public Health as a Share of GDP in China and Other Countries -- 5.1 Provincial and Central Government Subsidy Allocations across Counties within Selected Provinces -- 5.2 Inequality in County Government NRCMS Contributions -- 5.3 Making the Financing Mix Fairer for County Governments -- 5.4 "Surplus" Contributions in Jiangsu and Jiangxi Provinces -- 7.1 Government Expenditure on Disease Control by Province -- 7.2 Incidence of TB by Provincial GDP -- 7.3 Financing of Public Health Activities at the County Level -- 7.4 Central and Provincial Public Health Funds by County Activity -- 7.5 Vertical Control and Accountability in China's Public Health System -- 7.6 Where Is Money for Public Health Going? -- 7.7 Accounting for Public Health Spending by Institutional Type