The Long March to Universal Coverage : Lessons from China

The march to Universal Health Coverage (UHC) in China is unparalleled. Since the establishment of the State Council Medical Reform team in 2006,4 the basic objective of China's health reforms has been to provide the whole nation with basic medical and health care, while ensuring equal access to...

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Main Authors: Liang, Lilin, Langenbrunner, John C.
Format: Working Paper
Language:en_US
Published: World Bank, Washington DC 2013
Subjects:
Online Access:http://hdl.handle.net/10986/13303
id okr-10986-13303
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language en_US
topic Access to health services
access to services
accountability mechanisms
adverse selection
adverse selection problems
allocative efficiency
basic health care
basic health services
beds
breast cancer
budget allocation
care institutions
Center for Health
cervical cancer
cities
clinics
community health
community health services
contribution rate
cost control
cost structure
decision making
delivery system
developing countries
Development Goals
doctors
economic growth
elderly
elderly people
epidemic
equal access
equitable access
essential drugs
essential medicines
Expenditures
families
fee schedule
fee-for-service
fee-for-service system
financial barriers
financial contributions
financial incentives
Financial protection
financial risk
financial risk protection
financial risks
fiscal policies
fiscal policy
General Health System
general practitioners
global budgets
global campaign
health care
health care costs
health care delivery
health care reform
health care services
Health Care System
Health Care System Reform
health care workers
health centers
Health Coverage
health delivery
health delivery system
health education
Health Expenditure
Health Expenditures
health financing
health infrastructure
health institutions
health insurance coverage
health insurance program
health insurance scheme
Health Insurance Schemes
health insurance system
health management
Health Organization
health outcomes
health planning
health policy
health professionals
health programs
Health providers
health reform
health reforms
health resources
health sector
Health Service
health service utilization
Health Services
Health Status
Health System
health system reform
health systems
health workers
health workforce
healthcare services
hospital admission
Hospital admissions
hospital beds
hospital care
hospital cost
hospitalization
Hospitals
Human Resources
ill health
impact evaluations
impact on health outcomes
incentives for doctors
income
income countries
induced demand
informal sector
informatics
information system
information systems
inpatient care
insurance coverage
insurance funds
insurance premiums
insurers
integration
intervention
kidney diseases
large cities
laws
leukemia
living standards
local authorities
marginal costs
market economy
medical bills
medical care
medical education
medical expenses
Medical Insurance
medical records
medical resources
medical savings accounts
medical services
medical staff
medicines
mental illness
migrant
migrant workers
Ministry of Health
mortality
mortality rate
movement of People
National Development
National Health
national health expenditure
National Health Insurance
National Health Services
nurses
nursing
outpatient care
outpatient services
patient
patient outcomes
Patients
pharmaceutical companies
pharmacists
physician
physicians
pocket payment
policy framework
policy makers
political support
poor health
prescription drugs
primary care
Private Health Insurance
progress
provider incentives
provider payment
provision of care
psychiatric hospital
Public Health
Public Health Services
public health spending
public hospital
Public Hospitals
public sector
public services
public spending
quality care
quality of services
reimbursement rates
Rural Areas
rural health care
rural population
rural residents
safety net
school children
social development
social equity
social health insurance
Social Insurance
Social Security
Social Security benefits
Social Services
social welfare
tuberculosis
unemployment
universal access
urban areas
urbanization
vicious cycle
violence
waste
workers
working conditions
World Health Organization
spellingShingle Access to health services
access to services
accountability mechanisms
adverse selection
adverse selection problems
allocative efficiency
basic health care
basic health services
beds
breast cancer
budget allocation
care institutions
Center for Health
cervical cancer
cities
clinics
community health
community health services
contribution rate
cost control
cost structure
decision making
delivery system
developing countries
Development Goals
doctors
economic growth
elderly
elderly people
epidemic
equal access
equitable access
essential drugs
essential medicines
Expenditures
families
fee schedule
fee-for-service
fee-for-service system
financial barriers
financial contributions
financial incentives
Financial protection
financial risk
financial risk protection
financial risks
fiscal policies
fiscal policy
General Health System
general practitioners
global budgets
global campaign
health care
health care costs
health care delivery
health care reform
health care services
Health Care System
Health Care System Reform
health care workers
health centers
Health Coverage
health delivery
health delivery system
health education
Health Expenditure
Health Expenditures
health financing
health infrastructure
health institutions
health insurance coverage
health insurance program
health insurance scheme
Health Insurance Schemes
health insurance system
health management
Health Organization
health outcomes
health planning
health policy
health professionals
health programs
Health providers
health reform
health reforms
health resources
health sector
Health Service
health service utilization
Health Services
Health Status
Health System
health system reform
health systems
health workers
health workforce
healthcare services
hospital admission
Hospital admissions
hospital beds
hospital care
hospital cost
hospitalization
Hospitals
Human Resources
ill health
impact evaluations
impact on health outcomes
incentives for doctors
income
income countries
induced demand
informal sector
informatics
information system
information systems
inpatient care
insurance coverage
insurance funds
insurance premiums
insurers
integration
intervention
kidney diseases
large cities
laws
leukemia
living standards
local authorities
marginal costs
market economy
medical bills
medical care
medical education
medical expenses
Medical Insurance
medical records
medical resources
medical savings accounts
medical services
medical staff
medicines
mental illness
migrant
migrant workers
Ministry of Health
mortality
mortality rate
movement of People
National Development
National Health
national health expenditure
National Health Insurance
National Health Services
nurses
nursing
outpatient care
outpatient services
patient
patient outcomes
Patients
pharmaceutical companies
pharmacists
physician
physicians
pocket payment
policy framework
policy makers
political support
poor health
prescription drugs
primary care
Private Health Insurance
progress
provider incentives
provider payment
provision of care
psychiatric hospital
Public Health
Public Health Services
public health spending
public hospital
Public Hospitals
public sector
public services
public spending
quality care
quality of services
reimbursement rates
Rural Areas
rural health care
rural population
rural residents
safety net
school children
social development
social equity
social health insurance
Social Insurance
Social Security
Social Security benefits
Social Services
social welfare
tuberculosis
unemployment
universal access
urban areas
urbanization
vicious cycle
violence
waste
workers
working conditions
World Health Organization
Liang, Lilin
Langenbrunner, John C.
The Long March to Universal Coverage : Lessons from China
geographic_facet East Asia and Pacific
China
relation UNICO Study Series;No. 9
description The march to Universal Health Coverage (UHC) in China is unparalleled. Since the establishment of the State Council Medical Reform team in 2006,4 the basic objective of China's health reforms has been to provide the whole nation with basic medical and health care, while ensuring equal access to, and affordability of, health services. The Chinese government announced the national three-year reform plan in 2009, after which the country has made remarkable progress toward achieving nearly universal health coverage. The recent health reform initiatives under the 12th Five-Year Plan (2011-2015) continue to center on five areas. Building on recent experience, more effort is directed toward a structural change of the health system and building an environment that will facilitate policy implementation. This includes optimizing resource distribution, encouraging hospital competition, strengthening regulation and accountability, and enhancing human resources and information technology. While China has successfully extended the breadth of Health Coverage to the Poor (HCP), its scope (the comprehensiveness of services covered) and depth (the degree of financial risk protection) appear to be insufficient. Hospital admissions have increased significantly; suggesting improved access, up to 50 percent of current admissions may be amenable to more cost-effective outpatient care. Thus, it is critical to look into problems beyond the HCP program design, such as institutional arrangements, intergovernmental transfers, and supply constraints. This case study concludes with a discussion of the impacts of HCP and the needed next steps to advance HCP as an intermediate objective to the country's longer-term goals of equitable access and high quality of services.
format Publications & Research :: Working Paper
author Liang, Lilin
Langenbrunner, John C.
author_facet Liang, Lilin
Langenbrunner, John C.
author_sort Liang, Lilin
title The Long March to Universal Coverage : Lessons from China
title_short The Long March to Universal Coverage : Lessons from China
title_full The Long March to Universal Coverage : Lessons from China
title_fullStr The Long March to Universal Coverage : Lessons from China
title_full_unstemmed The Long March to Universal Coverage : Lessons from China
title_sort long march to universal coverage : lessons from china
publisher World Bank, Washington DC
publishDate 2013
url http://hdl.handle.net/10986/13303
_version_ 1764423143176273920
spelling okr-10986-133032021-04-23T14:03:07Z The Long March to Universal Coverage : Lessons from China Liang, Lilin Langenbrunner, John C. Access to health services access to services accountability mechanisms adverse selection adverse selection problems allocative efficiency basic health care basic health services beds breast cancer budget allocation care institutions Center for Health cervical cancer cities clinics community health community health services contribution rate cost control cost structure decision making delivery system developing countries Development Goals doctors economic growth elderly elderly people epidemic equal access equitable access essential drugs essential medicines Expenditures families fee schedule fee-for-service fee-for-service system financial barriers financial contributions financial incentives Financial protection financial risk financial risk protection financial risks fiscal policies fiscal policy General Health System general practitioners global budgets global campaign health care health care costs health care delivery health care reform health care services Health Care System Health Care System Reform health care workers health centers Health Coverage health delivery health delivery system health education Health Expenditure Health Expenditures health financing health infrastructure health institutions health insurance coverage health insurance program health insurance scheme Health Insurance Schemes health insurance system health management Health Organization health outcomes health planning health policy health professionals health programs Health providers health reform health reforms health resources health sector Health Service health service utilization Health Services Health Status Health System health system reform health systems health workers health workforce healthcare services hospital admission Hospital admissions hospital beds hospital care hospital cost hospitalization Hospitals Human Resources ill health impact evaluations impact on health outcomes incentives for doctors income income countries induced demand informal sector informatics information system information systems inpatient care insurance coverage insurance funds insurance premiums insurers integration intervention kidney diseases large cities laws leukemia living standards local authorities marginal costs market economy medical bills medical care medical education medical expenses Medical Insurance medical records medical resources medical savings accounts medical services medical staff medicines mental illness migrant migrant workers Ministry of Health mortality mortality rate movement of People National Development National Health national health expenditure National Health Insurance National Health Services nurses nursing outpatient care outpatient services patient patient outcomes Patients pharmaceutical companies pharmacists physician physicians pocket payment policy framework policy makers political support poor health prescription drugs primary care Private Health Insurance progress provider incentives provider payment provision of care psychiatric hospital Public Health Public Health Services public health spending public hospital Public Hospitals public sector public services public spending quality care quality of services reimbursement rates Rural Areas rural health care rural population rural residents safety net school children social development social equity social health insurance Social Insurance Social Security Social Security benefits Social Services social welfare tuberculosis unemployment universal access urban areas urbanization vicious cycle violence waste workers working conditions World Health Organization The march to Universal Health Coverage (UHC) in China is unparalleled. Since the establishment of the State Council Medical Reform team in 2006,4 the basic objective of China's health reforms has been to provide the whole nation with basic medical and health care, while ensuring equal access to, and affordability of, health services. The Chinese government announced the national three-year reform plan in 2009, after which the country has made remarkable progress toward achieving nearly universal health coverage. The recent health reform initiatives under the 12th Five-Year Plan (2011-2015) continue to center on five areas. Building on recent experience, more effort is directed toward a structural change of the health system and building an environment that will facilitate policy implementation. This includes optimizing resource distribution, encouraging hospital competition, strengthening regulation and accountability, and enhancing human resources and information technology. While China has successfully extended the breadth of Health Coverage to the Poor (HCP), its scope (the comprehensiveness of services covered) and depth (the degree of financial risk protection) appear to be insufficient. Hospital admissions have increased significantly; suggesting improved access, up to 50 percent of current admissions may be amenable to more cost-effective outpatient care. Thus, it is critical to look into problems beyond the HCP program design, such as institutional arrangements, intergovernmental transfers, and supply constraints. This case study concludes with a discussion of the impacts of HCP and the needed next steps to advance HCP as an intermediate objective to the country's longer-term goals of equitable access and high quality of services. 2013-05-06T16:18:27Z 2013-05-06T16:18:27Z 2013-01 http://hdl.handle.net/10986/13303 en_US UNICO Study Series;No. 9 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington DC Publications & Research :: Working Paper Publications & Research East Asia and Pacific China