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The reforms of the Chinese health care system: County level changes: The Jiangxi study

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  • Zheng, Xiang
  • Hillier, Sheila

Abstract

A survey of the economic performance of county hospitals in middle income counties in Jiangxi province was undertaken in 1989. The survey considered the impact of health policy changes in the P.R.C., especially cost recovery, decentralization, managerial changes and the promotion of traditional medicine. The financial records of county level hospitals and traditional medicine hospitals for the period 1980-1989 were examined, as were patient expenditures. Opinions of those responsible for policy execution were surveyed. The data showed that hospitals from which state subsidy had been removed had become dependent on medicine sales and increasing itemization of treatment to recover costs. The insurance status of patients influenced the length of stay and levels of payment. Uninsured peasants had a shorter stay and were charged more for items of treatment. Traditional Medicine hospitals saw more outpatients than County hospitals, but were more likely to have a deficit. They were also very dependent on medicine sales for income. Most officials questioned felt that the changing system caused problems, but at the same time were eager to invest in equipment as a source of revenue.

Suggested Citation

  • Zheng, Xiang & Hillier, Sheila, 1995. "The reforms of the Chinese health care system: County level changes: The Jiangxi study," Social Science & Medicine, Elsevier, vol. 41(8), pages 1057-1064, October.
    • Handle: RePEc:eee:socmed:v:41:y:1995:i:8:p:1057-1064
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    Cited by:

    1. Jin, Lei, 2010. "From mainstream to marginal? Trends in the use of Chinese medicine in China from 1991 to 2004," Social Science & Medicine, Elsevier, vol. 71(6), pages 1063-1067, September.
    2. Hu, Shu & Das, Dhiman, 2019. "Quality of life among older adults in China and India: Does productive engagement help?," Social Science & Medicine, Elsevier, vol. 229(C), pages 144-153.
    3. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    4. Wu, Yanrui, 1997. "China's health care sector in transition: resources, demand and reforms," Health Policy, Elsevier, vol. 39(2), pages 137-152, February.
    5. Khaleghian, Peyvand & Gupta, Monica Das, 2005. "Public management and the essential public health functions," World Development, Elsevier, vol. 33(7), pages 1083-1099, July.
    6. Jiwei Qian & Alex Jingwei He, 2018. "The Bonus Scheme, Motivation Crowding-out and Quality of the Doctor-Patient Encounters in Chinese Public Hospitals," Public Organization Review, Springer, vol. 18(2), pages 143-158, June.
    7. Dr B C Purohit, "undated". "Structural Adjustment and the Health Care Sector in India: some policy issues in financing," QEH Working Papers qehwps02, Queen Elizabeth House, University of Oxford.
    8. You, Xuedan & Kobayashi, Yasuki, 2009. "The new cooperative medical scheme in China," Health Policy, Elsevier, vol. 91(1), pages 1-9, June.
    9. David Chu & Kolleen Rask, 2002. "The Transformation of China's Health Care System and Accounting Methods: Current Reforms and Developments," Working Papers 0208, College of the Holy Cross, Department of Economics.
    10. Reynolds, Lucy & McKee, Martin, 2009. "Factors influencing antibiotic prescribing in China: An exploratory analysis," Health Policy, Elsevier, vol. 90(1), pages 32-36, April.
    11. David Chu & Kolleen Rask, 2000. "The Transformation of China’s Health Care System and Accounting Methods: Current Reforms and Developments," Working Papers 0003, College of the Holy Cross, Department of Economics.
    12. Gonzalez Block, Miguel Angel, 1997. "Comparative research and analysis methods for shared learning from health system reforms," Health Policy, Elsevier, vol. 42(3), pages 187-209, December.
    13. Miltiades, Helen B. & Wu, Bei, 2008. "Factors affecting physician visits in Chinese and Chinese immigrant samples," Social Science & Medicine, Elsevier, vol. 66(3), pages 704-714, February.

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