Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study
In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. We used data from the 2003, 2008, and 2011 National Health Services Surv...
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| Vydáno v: | The Lancet (British edition) Ročník 379; číslo 9818; s. 805 - 814 |
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| Hlavní autoři: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Kidlington
Elsevier Ltd
03.03.2012
Elsevier Elsevier Limited |
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| ISSN: | 0140-6736, 1474-547X, 1474-547X |
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| Abstract | In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide.
We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions.
The number of households interviewed was 57 023 in 2003, 56 456 in 2008, and 18 822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193 689 in 2003, 177 501 in 2008, and 59 835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57 526 of 193 689) to 95·7% (57 262 of 59 835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7–15·1) in 2003 to 46·9 (44·7–49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59 835, p<0·0001) in 2011 from 3·6% (6981 of 193 689) in 2003. 12·9% of households (2425 of 18 800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011.
Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care.
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| AbstractList | In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide.
We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions.
The number of households interviewed was 57 023 in 2003, 56 456 in 2008, and 18 822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193 689 in 2003, 177 501 in 2008, and 59 835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57 526 of 193 689) to 95·7% (57 262 of 59 835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7–15·1) in 2003 to 46·9 (44·7–49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59 835, p<0·0001) in 2011 from 3·6% (6981 of 193 689) in 2003. 12·9% of households (2425 of 18 800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011.
Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care.
None. BACKGROUND: In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. METHODS: We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions. FINDINGS: The number of households interviewed was 57 023 in 2003, 56 456 in 2008, and 18 822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193 689 in 2003, 177 501 in 2008, and 59 835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57 526 of 193 689) to 95·7% (57 262 of 59 835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7–15·1) in 2003 to 46·9 (44·7–49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59 835, p<0·0001) in 2011 from 3·6% (6981 of 193 689) in 2003. 12·9% of households (2425 of 18 800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011. INTERPRETATION: Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care. FUNDING: None. In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions. The number of households interviewed was 57 023 in 2003, 56 456 in 2008, and 18 822 in 2011. Response rates were 98.3%, 95.0%, and 95.5%, respectively. The number of individuals interviewed was 193 689 in 2003, 177 501 in 2008, and 59 835 in 2011. Between 2003 and 2011, insurance coverage increased from 29.7% (57 526 of 193 689) to 95.7% (57 262 of 59 835, p<0.0001). The average share of inpatient costs reimbursed from insurance increased from 14.4 (13.7-15.1) in 2003 to 46.9 (44.7-49.1) in 2011 (p<0.0001). Hospital delivery rates averaged 95.8% (1219 of 1272) in 2011. Hospital admissions increased 2.5 times to 8.8% (5288 of 59 835, p<0.0001) in 2011 from 3.6% (6981 of 193 689) in 2003. 12.9% of households (2425 of 18 800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19.2% (736 of 3835) to 36.3% (443 of 1221, p<0.0001) between 2003 and 2011. Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care. In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide.BACKGROUNDIn the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide.We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions.METHODSWe used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions.The number of households interviewed was 57,023 in 2003, 56,456 in 2008, and 18,822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193,689 in 2003, 177,501 in 2008, and 59,835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57,526 of 193,689) to 95·7% (57,262 of 59,835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7-15·1) in 2003 to 46·9 (44·7-49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59,835, p<0·0001) in 2011 from 3·6% (6981 of 193,689) in 2003. 12·9% of households (2425 of 18,800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011.FINDINGSThe number of households interviewed was 57,023 in 2003, 56,456 in 2008, and 18,822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193,689 in 2003, 177,501 in 2008, and 59,835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57,526 of 193,689) to 95·7% (57,262 of 59,835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7-15·1) in 2003 to 46·9 (44·7-49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59,835, p<0·0001) in 2011 from 3·6% (6981 of 193,689) in 2003. 12·9% of households (2425 of 18,800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011.Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care.INTERPRETATIONRemarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care.None.FUNDINGNone. Summary Background In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care access and financial protection between 2003, and 2011, nationwide. Methods We used data from the 2003, 2008, and 2011 National Health Services Survey (NHSS), which used multistage stratified cluster sampling to select 94 of 2859 counties from China's 31 provinces and municipalities. The 2011 survey was done with a subset of the NHSS sampling frame to monitor key indicators after the national health-care reforms were announced in 2009. Three sets of indicators were chosen to measure trends in access to coverage, health-care activities, and financial protection. Data were disaggregated by urban or rural residence and by three geographical regions: east, central, and west, and by household income. We examined change in equity across and within regions. Findings The number of households interviewed was 57 023 in 2003, 56 456 in 2008, and 18 822 in 2011. Response rates were 98·3%, 95·0%, and 95·5%, respectively. The number of individuals interviewed was 193 689 in 2003, 177 501 in 2008, and 59 835 in 2011. Between 2003 and 2011, insurance coverage increased from 29·7% (57 526 of 193 689) to 95·7% (57 262 of 59 835, p<0·0001). The average share of inpatient costs reimbursed from insurance increased from 14·4 (13·7–15·1) in 2003 to 46·9 (44·7–49·1) in 2011 (p<0·0001). Hospital delivery rates averaged 95·8% (1219 of 1272) in 2011. Hospital admissions increased 2·5 times to 8·8% (5288 of 59 835, p<0·0001) in 2011 from 3·6% (6981 of 193 689) in 2003. 12·9% of households (2425 of 18 800) had catastrophic health expenses in 2011. Caesarean section rates increased from 19·2% (736 of 3835) to 36·3% (443 of 1221, p<0·0001) between 2003 and 2011. Interpretation Remarkable increases in insurance coverage and inpatient reimbursement were accompanied by increased use and coverage of health care. Important advances have been made in achieving equal access to services and insurance coverage across and within regions. However, these increases have not been accompanied by reductions in catastrophic health expenses. With the achievement of basic health-services coverage, future challenges include stronger risk protection, and greater efficiency and quality of care. Funding None. |
| Author | Cai, Min Boerma, J Ties Xu, Ke Qian, Juncheng Xu, Ling Xin, Ying Barber, Sarah L Meng, Qun Zhang, Yaoguang Gao, Jun |
| Author_xml | – sequence: 1 givenname: Qun surname: Meng fullname: Meng, Qun organization: Centre for Health Statistics Information, Ministry of Health, People's Republic of China – sequence: 2 givenname: Ling surname: Xu fullname: Xu, Ling organization: Centre for Health Statistics Information, Ministry of Health, People's Republic of China – sequence: 3 givenname: Yaoguang surname: Zhang fullname: Zhang, Yaoguang organization: Centre for Health Statistics Information, Ministry of Health, People's Republic of China – sequence: 4 givenname: Juncheng surname: Qian fullname: Qian, Juncheng organization: Centre for Health Statistics Information, Ministry of Health, People's Republic of China – sequence: 5 givenname: Min surname: Cai fullname: Cai, Min organization: Centre for Health Statistics Information, Ministry of Health, People's Republic of China – sequence: 6 givenname: Ying surname: Xin fullname: Xin, Ying organization: Centre for Health Statistics Information, Ministry of Health, People's Republic of China – sequence: 7 givenname: Jun surname: Gao fullname: Gao, Jun organization: Division of Health Sector Development, WHO Western Pacific Regional Office, Manila, Philippines – sequence: 8 givenname: Ke surname: Xu fullname: Xu, Ke organization: Department of Health Financing, WHO, Geneva, Switzerland – sequence: 9 givenname: J Ties surname: Boerma fullname: Boerma, J Ties organization: Department of Health Statistics and Informatics, WHO, Geneva, Switzerland – sequence: 10 givenname: Sarah L surname: Barber fullname: Barber, Sarah L email: barber.sarah.louise@gmail.com organization: WHO, Beijing, China |
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| Cites_doi | 10.1002/hec.1306 10.1377/hlthaff.27.2.460 10.1002/hec.1518 10.1002/hec.1501 10.1016/S0140-6736(08)61362-8 10.1016/j.chieco.2009.05.011 10.1377/hlthaff.27.4.937 10.1016/j.socscimed.2010.01.026 10.1016/S0140-6736(06)68704-7 |
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| Copyright | 2012 Elsevier Ltd Elsevier Ltd 2015 INIST-CNRS Copyright © 2012 Elsevier Ltd. All rights reserved. Copyright Elsevier Limited Mar 3-Mar 9, 2012 |
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| References | (bib5) 2004 Yip, Hsiao (bib2) 2008; 27 Liu, Rao, Wu, Gakidou (bib6) 2008; 372 (bib4) 2009 (bib17) 2010 (bib11) 2009 Villar, Valladares, Wojdyla (bib19) 2006; 367 (bib12) 2009 Eggleston, Ling, Qingyue, Lindelow, Wagstaff (bib10) 2008; 17 Yan (bib13) May 30, 2011 Bogg, Huang, Long, Shen, Hemminki (bib18) 2010; 70 Ma, Lu, Quan (bib1) 2008; 27 Barber, Lan (bib7) 2010 Nabar (bib14) 2011 (bib16) 2011 (bib15) 2011 Wagstaff, Yip, Lindelow, Hsiao (bib3) 2009; 18 Dong (bib8) 2009; 20 Lei, Lin (bib9) 2009; 18 Ma (10.1016/S0140-6736(12)60278-5_bib1) 2008; 27 Yip (10.1016/S0140-6736(12)60278-5_bib2) 2008; 27 Eggleston (10.1016/S0140-6736(12)60278-5_bib10) 2008; 17 (10.1016/S0140-6736(12)60278-5_bib15) 2011 (10.1016/S0140-6736(12)60278-5_bib5) 2004 Lei (10.1016/S0140-6736(12)60278-5_bib9) 2009; 18 Nabar (10.1016/S0140-6736(12)60278-5_bib14) 2011 (10.1016/S0140-6736(12)60278-5_bib11) 2009 (10.1016/S0140-6736(12)60278-5_bib16) 2011 Bogg (10.1016/S0140-6736(12)60278-5_bib18) 2010; 70 Yan (10.1016/S0140-6736(12)60278-5_bib13) 2011 (10.1016/S0140-6736(12)60278-5_bib17) 2010 (10.1016/S0140-6736(12)60278-5_bib4) 2009 (10.1016/S0140-6736(12)60278-5_bib12) 2009 Barber (10.1016/S0140-6736(12)60278-5_bib7) 2010 Liu (10.1016/S0140-6736(12)60278-5_bib6) 2008; 372 Wagstaff (10.1016/S0140-6736(12)60278-5_bib3) 2009; 18 Dong (10.1016/S0140-6736(12)60278-5_bib8) 2009; 20 Villar (10.1016/S0140-6736(12)60278-5_bib19) 2006; 367 Lancet. 2012 Sep 8;380(9845):888 22386010 - Lancet. 2012 Mar 3;379(9818):777 22386015 - Lancet. 2012 Mar 3;379(9818):782-3 |
| References_xml | – year: 2010 ident: bib7 publication-title: Health insurance systems in China: a briefing note. World Health report (2010) background paper 37 – volume: 27 start-page: 460 year: 2008 end-page: 468 ident: bib2 article-title: The Chinese health system at a crossroads publication-title: Health Aff (Millwood) – year: 2011 ident: bib16 publication-title: Chinese health statistical digest – volume: 372 start-page: 1914 year: 2008 end-page: 1923 ident: bib6 article-title: China's health system performance publication-title: Lancet – volume: 70 start-page: 1544 year: 2010 end-page: 1549 ident: bib18 article-title: Dramatic increase of cesarean deliveries in the midst of health reforms in rural China publication-title: Soc Sci Med – volume: 20 start-page: 591 year: 2009 end-page: 597 ident: bib8 article-title: Medical insurance system evolution in China publication-title: China Econ Rev – start-page: 77 year: 2009 ident: bib4 publication-title: China National Health Accounts Report 2008 – year: 2010 ident: bib17 publication-title: Organization for Economic Cooperation and Development (OECD) Health Data 2010 – volume: 367 start-page: 1819 year: 2006 end-page: 1829 ident: bib19 article-title: Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America publication-title: Lancet – year: 2009 ident: bib11 publication-title: State Council. Opinions of the Communist Party of China Central Committee and the State Council on Deepening the Health Care System Reform – year: 2011 ident: bib15 publication-title: China Health Statistical Yearbook 2011 – volume: 27 start-page: 937 year: 2008 end-page: 948 ident: bib1 article-title: From a national, centrally planned health system to a system based on the market: lessons from China publication-title: Health Aff (Millwood) – year: 2009 ident: bib12 publication-title: State Council implementation plan for the recent priorities of the health care system reform (2009–2011) – year: May 30, 2011 ident: bib13 article-title: China weaves world largest net of medical care publication-title: Xinhua English News – volume: 18 start-page: S7 year: 2009 end-page: 23 ident: bib3 article-title: China's health system and its reform: a review of recent studies publication-title: Health Econ – volume: 18 start-page: S25 year: 2009 end-page: S46 ident: bib9 article-title: The new cooperative medical scheme in rural China: does more coverage mean more service and better health? publication-title: Health Econ – year: 2004 ident: bib5 publication-title: Center for Health Statistics and Information, Reports of Nation Health Service Survey Summary – volume: 17 start-page: 149 year: 2008 end-page: 165 ident: bib10 article-title: Health service delivery in China: a literature review publication-title: Health Econ – year: 2011 ident: bib14 publication-title: Targets, interest rates, and household saving in urban China. Working Paper WP/11/223 – year: 2010 ident: 10.1016/S0140-6736(12)60278-5_bib7 – year: 2009 ident: 10.1016/S0140-6736(12)60278-5_bib11 – year: 2011 ident: 10.1016/S0140-6736(12)60278-5_bib13 article-title: China weaves world largest net of medical care publication-title: Xinhua English News – year: 2011 ident: 10.1016/S0140-6736(12)60278-5_bib16 – volume: 17 start-page: 149 year: 2008 ident: 10.1016/S0140-6736(12)60278-5_bib10 article-title: Health service delivery in China: a literature review publication-title: Health Econ doi: 10.1002/hec.1306 – year: 2009 ident: 10.1016/S0140-6736(12)60278-5_bib12 – volume: 27 start-page: 460 year: 2008 ident: 10.1016/S0140-6736(12)60278-5_bib2 article-title: The Chinese health system at a crossroads publication-title: Health Aff (Millwood) doi: 10.1377/hlthaff.27.2.460 – volume: 18 start-page: S7 issue: suppl 2 year: 2009 ident: 10.1016/S0140-6736(12)60278-5_bib3 article-title: China's health system and its reform: a review of recent studies publication-title: Health Econ doi: 10.1002/hec.1518 – volume: 18 start-page: S25 issue: suppl 2 year: 2009 ident: 10.1016/S0140-6736(12)60278-5_bib9 article-title: The new cooperative medical scheme in rural China: does more coverage mean more service and better health? publication-title: Health Econ doi: 10.1002/hec.1501 – year: 2011 ident: 10.1016/S0140-6736(12)60278-5_bib14 – start-page: 77 year: 2009 ident: 10.1016/S0140-6736(12)60278-5_bib4 – year: 2011 ident: 10.1016/S0140-6736(12)60278-5_bib15 – volume: 372 start-page: 1914 year: 2008 ident: 10.1016/S0140-6736(12)60278-5_bib6 article-title: China's health system performance publication-title: Lancet doi: 10.1016/S0140-6736(08)61362-8 – volume: 20 start-page: 591 year: 2009 ident: 10.1016/S0140-6736(12)60278-5_bib8 article-title: Medical insurance system evolution in China publication-title: China Econ Rev doi: 10.1016/j.chieco.2009.05.011 – year: 2010 ident: 10.1016/S0140-6736(12)60278-5_bib17 – year: 2004 ident: 10.1016/S0140-6736(12)60278-5_bib5 – volume: 27 start-page: 937 year: 2008 ident: 10.1016/S0140-6736(12)60278-5_bib1 article-title: From a national, centrally planned health system to a system based on the market: lessons from China publication-title: Health Aff (Millwood) doi: 10.1377/hlthaff.27.4.937 – volume: 70 start-page: 1544 year: 2010 ident: 10.1016/S0140-6736(12)60278-5_bib18 article-title: Dramatic increase of cesarean deliveries in the midst of health reforms in rural China publication-title: Soc Sci Med doi: 10.1016/j.socscimed.2010.01.026 – volume: 367 start-page: 1819 year: 2006 ident: 10.1016/S0140-6736(12)60278-5_bib19 article-title: Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America publication-title: Lancet doi: 10.1016/S0140-6736(06)68704-7 – reference: - Lancet. 2012 Sep 8;380(9845):888 – reference: 22386010 - Lancet. 2012 Mar 3;379(9818):777 – reference: 22386015 - Lancet. 2012 Mar 3;379(9818):782-3 |
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| Snippet | In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in health-care... Summary Background In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed... BACKGROUND: In the past decade, the Government of China initiated health-care reforms to achieve universal access to health care by 2020. We assessed trends in... |
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| SubjectTerms | Administrative support Adolescent Adult Aged Biological and medical sciences cesarean section Cesarean Section - economics Child Child, Preschool China Cluster Analysis Cross-Sectional Studies Delivery, Obstetric - economics Delivery, Obstetric - statistics & numerical data Delivery, Obstetric - trends Design Family income Female General aspects Health care Health care access Health care policy Health facilities Health insurance Health services Health Services Accessibility - economics Health Services Accessibility - statistics & numerical data Health Services Accessibility - trends Hospital Costs - statistics & numerical data Hospitals household income Households Humans insurance Insurance Coverage - economics Insurance Coverage - statistics & numerical data Insurance Coverage - trends Insurance, Health - economics Insurance, Health - trends Internal Medicine Interviews Male Medical sciences Middle Aged Miscellaneous Monitoring systems National Health Programs - economics National Health Programs - statistics & numerical data National Health Programs - trends Patient Admission - economics Patient Admission - statistics & numerical data Patient Admission - trends Public health. Hygiene Public health. Hygiene-occupational medicine risk Rural areas Rural Population Socioeconomic Factors surveys Trends Urban areas Young Adult |
| Title | Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study |
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