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Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing

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  • Zhang, Xuanchuan
  • Chen, Li-Wu
  • Mueller, Keith
  • Yu, Qiao
  • Liu, Jiapeng
  • Lin, Ge

Abstract

Objectives To track and evaluate the effectiveness since 2007 of urban health reform policies in Beijing that provided universal health insurance and strengthened local government-owned community health centers (CHCs).Methods Pre- and post-reform data on outpatient visits, staff, and financial statements among all CHCs in a district in Beijing were analyzed by the nonparametric Kruskal-Wallis method. Field surveys were also conducted to supplement the statistical analysis.Results The post-reform data showed a substantial increase in outpatient visits at the district level, but the number of outpatient visits was flat at the CHC level. In addition, short-term CHC responses to reform policies, such as employment growth, and operating expense-to-revenue ratio, have not been cost effective.Conclusion The overall increase in outpatient visits at the district level, including at large hospitals, conceals the fact that CHCs within the district were unable to attract a greater number of patients. The lack of operational efficiency in the process of establishing and transforming CHCs may put the primary care system at financial risk in the long run. Well-synchronized policy measures should be considered in future reforms, especially in shaping the behaviors of patients, CHCs, and physicians.

Suggested Citation

  • Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2-3), pages 181-188, May.
    • Handle: RePEc:eee:hepoli:v:100:y:2011:i:2-3:p:181-188
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    Citations

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    Cited by:

    1. Hao Zhang & Huimei Hu & Christina Wu & Hai Yu & Hengjin Dong, 2015. "Impact of China's Public Hospital Reform on Healthcare Expenditures and Utilization: A Case Study in ZJ Province," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
    2. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    3. Guanghui Jin & Yali Zhao & Chao Chen & Wenji Wang & Juan Du & Xiaoqin Lu, 2015. "The Length and Content of General Practice Consultation in Two Urban Districts of Beijing: A Preliminary Observation Study," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-10, August.
    4. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.
    5. Yanchen Liu & Yingchun Chen & Xueyan Cheng & Yan Zhang, 2020. "Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(16), pages 1-14, August.
    6. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.
    7. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.

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