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Consumer price index and healthcare price index 1951 to 2009
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Under the influence of national economic reform and development, China has changed the way that it finances healthcare from a government-based system to a more market-oriented system. China has done this without a sophisticated healthcare payment system, and this has resulted in the rapid growth of health expenditures and many Chinese not being abl...
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With the rising health care cost, increase in disposable income and high out-of-pocket expenditure for funding healthcare, the only way forward for financing healthcare in a country like India is through Health insurance mechanism. There are multiple stakeholders involved in the Health insurance mechanism and have different issues and
interest. The...
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... While China has regulations it has followed a cost plus approach to pricing and at the same time provided sufficient margins to retailers and wholesalers. There are areas of improvement in the Chinese healthcare system as well (Ying et al., 2012), the government funding needs to be increase to make the hospitals self-sufficient so that they don't have to depend in service based revenues to break even. China may have to look towards a balance between, government spend, employers spend and individual spend to drive improvements in healthcare financing. ...
Purpose-With increased demand and restricted healthcare resources, it becomes important to take a step back and evaluate the efficiency of healthcare delivery. The present study aims to evaluate the health system efficiency of India by benchmarking it against its peers in BRICS countries and against OECD countries. Design/Methodology/Approach: The input and output variables required for measuring the efficiency of healthcare system were identified. A Data Envelopment Analysis (DEA) approach was used and efficiency frontier identified with the rankings of the BRICS and OECD countries. India is thus benchmarked against its peers (BRICS) and against OECD countries. Finding: India was found to operate at the efficiency frontier along with China, Russia, Brazil, and South Africa, however it ranked fourth. When benchmarked against OECD countries, India operates on the efficiency frontier along with Canada, Greece, Japan, Korea, Mexico, Spain, Sweden, Switzerland, Turkey, Great Britain, Chile and Israel. Countries like Germany, United States of America, Czech Republic, Slovakia and Lithuania operate at a lower healthcare efficiency and need to use their resources wisely. Practical/Research Implications: Developing countries like India can look to improve its healthcare system delivery by replicating best practices of healthcare systems from its peers and the top 10 OECD countries. Majority of the OECD countries in the top 10 have implemented universal health coverage, have higher physician and nurse density and higher hospital bed ratios. They are inclined towards branded drugs vis-à-vis generics and have follow evidence based medicine. From a theoretical perspective, it adds to the body of literature of DEA and health system efficiency. Originality/Value: This is a pioneer study that benchmarks India against its peers and against OECD countries drawing unique insights about healthcare efficiency
... The increase of healthcare expenditure is much faster than that of healthcare budgets. Therefore, the skyrocketing rise in healthcare expenditures has become a heavy financial burden to patients, and poses a financial crisis to the healthcare system in China (Wang et al., 2012). ...
China has long faced the problem of having health care that is difficult to access. Online patient-provider communication (OPPC) may offer a new option for the delivery of affordable health services in a timely manner. However, OPPC is still novel in China, particularly among middle-aged and older adults. Thus, to promote effective use of OPPC for these population groups, the current study implemented a four-week Internet-based intervention program, with a general basis of Social Cognitive Theory. With analyses of three-wave panel data, the results offer the promise of this intervention program in increasing usage frequency, quality of users’ experience, self-efficacy, behavioral capability, and awareness of OPPC. This Internet-based intervention program also provides important implications for future research, practice, and policy in promoting e-Health in China.
... For example, the government funding for BPHS in Beijing is triple the national standard [50], while in other provinces it is near or lower than national standard. This is one major obstacle to providing high-level public health services in many rural areas [51]. Secondly, although THCs are required to allocate no less than 40 % of government funding of BPHS to village doctors, the specific proportion actually received is uncertain [48]. ...
Background:
To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China.
Methods:
Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models.
Results:
The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100).
Conclusion:
Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.
... In other words, the new policy moderately alleviates the problem, but further efforts are needed. We find that the reason of not having many new village doctors entering the workforce is that being a village doctor is not an attractive profession in terms of financial and career rewarding, which is consistent with findings of other studies (Ding et al., 2013;Shi et al., 2013) Inadequate funding is always one of major obstacles for providing good health services in many rural areas (Wang et al., 2012). Although policies have focused on funding equalization of public health services (State Council of China, 2009;Ministry of Health, 2011), only a small portion of the government funding is used for compensating village doctors. ...
As the most important public health service providers in rural China, village doctors are facing a new challenge of heavier workload resulting from the recent policy of public health service equalization. Studies on the shortage of village doctors, mainly based on the national statistics, have so far been very broad. This study conducted detailed field surveys to identify specific factors of and potential solutions to the shortage in village doctors.
Eight hundred forty‐four village doctors and 995 health decision makers and providers were surveyed through a questionnaire, and some of them were surveyed by in‐depth face‐to‐face interviews and focus group interviews. Opinions on the shortage in village doctors and the potentially effective approaches to addressing the problem were sought.
Some village doctors (51.3%) were at least 50 years old.
Some village doctors (92.3%) did not want their children to become a village doctor, and the main reasons were “low salary” and “lack of social security”. Village doctors felt that it was difficult to provide all the required public health services. Local residents indicated that they established good relationships with village doctors. Some health decision makers and providers (74.0%) thought that they needed more village doctors.
The shortage in village doctors presents a major obstacle toward the realization of China's policy of public health service equalization. The aging of current village doctors exacerbates the problem. Policies and programs are needed to retain the current and attract new village doctors into the workforce. Separate measures are also needed to address disparities in socioeconomic circumstance from village to village. Copyright © 2014 John Wiley & Sons, Ltd.
... The New Cooperative Medical Scheme has achieved the coverage of 90% or higher [18], but the level of compensation varies greatly across areas and is not high in most areas in rural China. Given the current high proportion of out-of-pocket pay- ment [24], a more important step is to increase the level of reimbursement. ...
Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China.
Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants.
The incidence of household catastrophic medical expenses in eastern China ranged from 9.24% to 24.79%. Incidence of household catastrophic medical expenses was lower if the head of household had a higher level of education, labor insurance coverage, while the incidence was higher if they lived in rural areas, had a family member with chronic diseases, had a child younger than 5 years old, had a person at home who was at least 65 years old, and had a household member who was hospitalized. Moreover, the impact of the economic level on catastrophic medical expenses was non-linear. The poorest group had a lower incidence than that of the second lowest income group and the group with the highest income had a higher incidence than that of the second highest income group. In addition, region was a significant determinant.
Reducing the incidence of household catastrophic medical expenses should be one of the priorities of health policy. It can be achieved by improving residents' health status to reduce avoidable health services such as hospitalization. It is also important to design more targeted health insurance in order to increase financial support for such vulnerable groups as the poor, chronically ill, children, and senior populations.
This chapter surveys informal payments in health systems around the world, especially those in post-socialist countries, and examines the negative impacts of the practice on health financing and reform and on patient’s medical behaviors. It then evaluates the definitions of informal payments given by international scholars, and those of red packets by the Chinese government and scholars, and proposes a definition of the red packet that is followed in this book.
Background Since the market economy reform healthcare expenditures have escalated in China, especially out-of-pocket payments. A new policy intervention begun in 2005, aimed to reshape the health care system. Objectives To examine effects of the new health care reform on hospital performance and patients' economic burdens in China, and provide evidence of the need for further public hospital reform in China. Methods Discharge records from 2005-2011 in a tertiary cancer hospital were abstracted. Changes in total charges, revenue structures, length of hospital stay and illness burden of patients were analyzed. Results During the seven-year period, total charges per discharge increased at a cumulative growth rate of 7.0%, which was far slower than that of the local GDP (105.9%). The hospital volume increased by 138.9%, annual revenues grew by 206.4%, and average length of stay declined by 28.4%. Prescription drugs accounted for 60.2% of the revenues. The ratio of total hospital charges to the per capita annual disposable income decreased from 1.38 to 0.84, and the percentage of out-of-pocket payment was reduced by 20 percent. Similar trends were observed in the national statistics. Conclusions The new health reform policy showed positive effects on alleviating both hospital operation and patients' economic burden; however, only short-term effects on containing the increase in total charges of hospitalization were observed. The highest proportion of hospital revenues was generated from prescription drugs, and the lowest proportion from bed fees and nursing fees which remained virtually unchanged. More effective approaches are merited to adjust hospitals' revenue structure and make hospital care more efficient.
