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Health service delivery in China: a literature review
Author(s) -
Eggleston Karen,
Ling Li,
Qingyue Meng,
Lindelow Magnus,
Wagstaff Adam
Publication year - 2008
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.1306
Subject(s) - china , service delivery framework , purchasing , equity (law) , service provider , business , service (business) , schedule , health care , economics , public economics , actuarial science , public relations , marketing , economic growth , political science , management , law
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.