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Health service delivery in China: a literature review

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  • Karen Eggleston

    (UCLA International Institute, Los Angeles, CA, USA)

  • Li Ling

    (China Center for Economic Research, Peking University, Beijing, China)

  • Meng Qingyue

    (Centre for Health Management and Policy, Shandong University, Jinan, China)

  • Magnus Lindelow

    (The World Bank, Washington, DC, USA)

  • Adam Wagstaff

    (The World Bank, Washington, DC, USA)

Abstract

We report the results of a review of the Chinese- and English-language literatures on service delivery in China, asking how well China's health-care providers perform and what determines their performance. Although data and methodological limitations suggest caution in drawing conclusions, a critical reading of the available evidence suggests that current health service delivery in China leaves room for improvement, in terms of quality, responsiveness to patients, efficiency, cost escalation, and equity. The literature suggests that these problems will not be solved by simply shifting ownership to the private sector or by simply encouraging providers - public and private - to compete with one another for individual patients. By contrast, substantial improvements could be (and in some places have already been) made by changing the way providers are paid - shifting away from fee-for-service and the distorted price schedule. Other elements of 'active purchasing' by insurers could further improve outcomes. Rigorous evaluations, based on richer micro-level data, could considerably strengthen the evidence base for service delivery policy in China. Copyright © 2007 by the International Bank for Reconstruction and Development|The World Bank, 1818 H Street, NW, Washington, DC 20433, U.S.A. Published by John Wiley & Sons, Ltd.

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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): 2 ()
Pages: 149-165

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Handle: RePEc:wly:hlthec:v:17:y:2008:i:2:p:149-165

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Liu, Xingzhu & Hsiao, William C. L., 1995. "The cost escalation of social health insurance plans in China: Its implication for public policy," Social Science & Medicine, Elsevier, vol. 41(8), pages 1095-1101, October.
  2. Kanbur, Ravi & Zhang, Xiaobo, 2003. "Spatial Inequality in Education and Health Care in China," CEPR Discussion Papers 4136, C.E.P.R. Discussion Papers.
  3. Liu, Yuanli & Berman, Peter & Yip, Winnie & Liang, Haocai & Meng, Qingyue & Qu, Jiangbin & Li, Zhonghe, 2006. "Health care in China: The role of non-government providers," Health Policy, Elsevier, vol. 77(2), pages 212-220, July.
  4. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
  5. Oliver Hart & Andrei Shleifer & Robert W. Vishny, 1996. "The Proper Scope of Government: Theory and an Application to Prisons," NBER Working Papers 5744, National Bureau of Economic Research, Inc.
  6. Sloan, Frank A., 2000. "Not-for-profit ownership and hospital behavior," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 21, pages 1141-1174 Elsevier.
  7. Ravallion, Martin & Chen, Shaohua, 2007. "China's (uneven) progress against poverty," Journal of Development Economics, Elsevier, vol. 82(1), pages 1-42, January.
  8. Yip, Winnie & Eggleston, Karen, 2004. "Addressing government and market failures with payment incentives: Hospital reimbursement reform in Hainan, China," Social Science & Medicine, Elsevier, vol. 58(2), pages 267-277, January.
  9. Meng, Qingyue & Rehnberg, Clas & Zhuang, Ning & Bian, Ying & Tomson, Goran & Tang, Shenglan, 2004. "The impact of urban health insurance reform on hospital charges: a case study from two cities in China," Health Policy, Elsevier, vol. 68(2), pages 197-209, May.
  10. Winnie Yip & Karen Eggleston, 2001. "Provider payment reform in China: the case of hospital reimbursement in Hainan province," Health Economics, John Wiley & Sons, Ltd., vol. 10(4), pages 325-339.
  11. April Harding & Alexander S. Preker, 2003. "Private Participation in Health Services," World Bank Publications, The World Bank, number 15147, July.
  12. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 577-615, May.
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