Fixing the Public Hospital System in China

In recent years, Chinese health care has improved rapidly, especially in the areas of equity and accessibility of services, as well as the movement toward universal coverage. A new round of health care reform, which was announced in April 2009, began implementation in 2010, with reform pilots in 16 urban areas. This paper analyzes a key pillar of this ongoing reform process, public hospital management. First, the paper reviews the history of public hospital reform, discusses hospital functions and responsibilities, and describes the structure and supply of health services. Second, it describes the main policy issues facing public hospitals, including financing sources and the hospital market environment. Third, it examines organizational arrangements in public hospitals, focusing on decision rights and governance. Fourth, the paper offers an international perspective and framework for assessing hospital reform. Finally, it summarizes the main policy issues and suggests next steps for policy reform. The paper draws on recent publications, grey literature, media reports, and interviews with key stakeholders.

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Bibliographic Details
Main Author: World Bank
Format: Policy Note biblioteca
Language:English
en_US
Published: Washington, DC 2010
Subjects:ACUTE CARE, ACUTE CARE HOSPITALS, ADEQUATE FOOD, ADMINISTRATIVE SERVICES, AGING, BABY, BASIC HEALTH SERVICES, BEDS, BRAIN DRAIN, CERTIFICATION, CHILD CARE, CHILD HEALTH, CITIES, CITIZENS, CLINICIAN, CLINICIANS, CLINICS, COMMUNITIES, COMMUNITY HEALTH, COMMUNITY HOSPITALS, COUNSELING, DESCRIPTION, DEVELOPMENT STRATEGIES, DIAGNOSIS, DISASTERS, DISEASE CONTROL, DOCTORS, DRUGS, EARTHQUAKE, ECONOMIC DEVELOPMENT, ECONOMIC POLICY, EMERGENCIES, EMERGENCY CASES, EMERGENCY MEDICAL SERVICES, EMERGENCY SERVICES, EMPLOYMENT, EXPENDITURE CONTROL, EXPENDITURES, EXPOSURE, FAMILIES, FAMILY PLANNING, FAMILY PLANNING SERVICES, FEE-FOR-SERVICE, FEES FOR SERVICES, FINANCIAL MANAGEMENT, FINANCING POLICIES, FIXED COSTS, GOVERNMENT DEPARTMENTS, GOVERNMENT OFFICES, GOVERNMENT POLICIES, GOVERNMENT PROMOTION, GOVERNMENT SUPPORT, HEALTH ADMINISTRATION, HEALTH AUTHORITIES, HEALTH CARE, HEALTH CARE REFORM, HEALTH CENTERS, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH INSTITUTIONS, HEALTH INSURANCE, HEALTH ORGANIZATIONS, HEALTH OUTCOMES, HEALTH PLANS, HEALTH POLICIES, HEALTH POLICY, HEALTH PROJECTS, HEALTH PROMOTION, HEALTH PROVIDERS, HEALTH REFORM, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICE PROVIDERS, HEALTH SERVICES, HEALTH SYSTEM, HEALTH SYSTEM REFORM, HEALTH-SECTOR, HEALTHCARE, HEALTHCARE PROVIDERS, HEALTHCARE SERVICES, HOSPITAL, HOSPITAL ADMINISTRATORS, HOSPITAL AUTONOMY, HOSPITAL BEDS, HOSPITAL CARE, HOSPITAL MANAGEMENT, HOSPITAL MANAGERS, HOSPITAL PERSONNEL, HOSPITAL SERVICES, HOSPITALS, HOUSEHOLDS, HOUSING, HOUSING CONSTRUCTION, HUMAN RESOURCE DEVELOPMENT, HUMAN RESOURCES, ILLNESSES, INCOME, INDUCED DEMAND, INFANT, INFANT MORTALITY, INFECTIOUS DISEASES, INFORMATION SYSTEM, INFORMATION SYSTEMS, INFRASTRUCTURE CONSTRUCTION, INSURANCE, INSURANCE COVERAGE, INSURANCE SCHEMES, INSURERS, INTERVENTION, LARGE CITIES, LEASING, LIFE EXPECTANCY, LIVING STANDARDS, LOCAL GOVERNMENTS, MANAGEMENT SYSTEMS, MANDATES, MATERNAL HEALTH, MEDICAL CARE, MEDICAL EDUCATION, MEDICAL EQUIPMENT, MEDICAL EXPENSES, MEDICAL FACILITIES, MEDICAL PERSONNEL, MEDICAL SERVICES, MEDICAL STAFF, MEDICAL TECHNOLOGY, MEDICAL TREATMENT, MEDICINES, MINISTRY OF HEALTH, MORTALITY, MORTGAGES, NATIONAL DEVELOPMENT, NATURAL DISASTERS, NURSING, NURSING HOMES, NUTRITION, OCCUPANCY, OCCUPANCY RATES, OPEN DOOR, OUTPATIENT CARE, OUTPATIENT SERVICES, PATIENT, PATIENT CHOICE, PATIENT SATISFACTION, PATIENTS, PHARMACIES, PHARMACY, PHYSICIAN, PHYSICIANS, PHYSIOTHERAPY, POOR FAMILIES, PRACTITIONERS, PRESCRIPTIONS, PREVENTIVE HEALTH CARE, PREVENTIVE HEALTH SERVICES, PRIMARY CARE, PROGRESS, PROVIDER PAYMENT, PUBLIC HEALTH, PUBLIC HEALTH SERVICES, PUBLIC HOSPITALS, PUBLIC SERVICE, QUALITY OF CARE, QUALITY OF SERVICES, QUALITY SERVICES, RADIOLOGY, REGIONAL PLANNING, REHABILITATION, RESEARCH PROJECTS, RURAL AREAS, RURAL POPULATION, RURAL RESIDENTS, SAFETY, SCREENING, SERVICE DELIVERY, SERVICE PROVISION, SERVICE QUALITY, SET OF RECOMMENDATIONS, SOCIAL HEALTH INSURANCE, SOCIAL RESPONSIBILITIES, SOCIAL SECURITY, SOCIAL SUPPORT, SOCIAL WELFARE, SOCIALIZATION, SURGERY, TEACHING HOSPITALS, TREATMENT SERVICES, TREATMENTS, URBAN AREAS, USE OF RESOURCES, VILLAGES, VISITS, VULNERABLE GROUPS, WASTE, WORKERS,
Online Access:http://documents.worldbank.org/curated/en/947791468242107797/Main-report
https://hdl.handle.net/10986/27720
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Summary:In recent years, Chinese health care has improved rapidly, especially in the areas of equity and accessibility of services, as well as the movement toward universal coverage. A new round of health care reform, which was announced in April 2009, began implementation in 2010, with reform pilots in 16 urban areas. This paper analyzes a key pillar of this ongoing reform process, public hospital management. First, the paper reviews the history of public hospital reform, discusses hospital functions and responsibilities, and describes the structure and supply of health services. Second, it describes the main policy issues facing public hospitals, including financing sources and the hospital market environment. Third, it examines organizational arrangements in public hospitals, focusing on decision rights and governance. Fourth, the paper offers an international perspective and framework for assessing hospital reform. Finally, it summarizes the main policy issues and suggests next steps for policy reform. The paper draws on recent publications, grey literature, media reports, and interviews with key stakeholders.