Privatization and Its Discontents—The Evolving Chinese Health Care System

Department of Health Policy and Management , Harvard University, Cambridge, Massachusetts, United States
New England Journal of Medicine (Impact Factor: 55.87). 10/2005; 353(11):1165-70. DOI: 10.1056/NEJMhpr051133
Source: PubMed

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    • "Furthermore, private healthcare systems tend to lack published data by which to evaluate their performance (Basu et al., 2012). Privatization compromises equity and accessibility for poor and vulnerable populations in particular (e.g., Palmer, 2014), as user fees instituted in private clinics deter ill people from seeking care or adhering to treatments (e.g., Baker, 2014; Basu et al., 2012; Blumenthal & Hsiao, 2005; Herrera, 2014; Navarro et al., 2006). In contrast, public clinics are subsidized by the government and thus have limited or no costs to patients, and studies emphasize the costs for prescription drugs are significantly lower in public clinics in comparison to private providers (e.g., Basu et al., 2012). "
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    ABSTRACT: Tuberculosis remains a persistent global health problem and key threat to development in poor countries. While many nations pursue privatization of healthcare, some accounts suggest that private health services are inadequate in addressing the TB burden. We utilize panel regression to empirically investigate data from 99 less-developed nations from 1995 to 2010. The results illustrate private health expenditures do not significantly impact TB rates, while public health expenditures reduce TB rates in developing nations over time. Thus, we caution against international development strategies which promote cuts in public spending and encourage privatization of healthcare as a means to stimulate growth or efficiency.
    Full-text · Article · Feb 2016 · World Development
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    • "This reform was anchored on five interdependent aspects: expanding healthcare coverage to over 90 % of the population, establishing a national essential medicine system to meet all the citizens' primary needs for medicine, improving primary care delivery system to provide basic health care and to manage referrals to hospitals' specialists, making public health services available and equitable to all, and steering public hospitals reforms[7,76,77]. Before announcing the new healthcare system reform, the Chinese government was faced with widespread public discontent that stemmed from the following factors: unaffordable access to health care, major financial risks associated with out-of-pocket health expenditures, and growing inequalities in accessing healthcare and health services across populations with different socioeconomic status, as well as between urban and rural areas787980818283. Meanwhile , a few of the previously eradicated infectious diseases had re-emerged, whereas non-communicable diseases (NCDs) increased unabatedly848586. "
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    ABSTRACT: Background In recent years, China’s healthcare reforms and related studies have drawn particular global attention. The main objective of this study is to evaluate quantitatively the publication trends and collaboration performance of China in healthcare science and services (HSS) research. Methods Scientometric methods and visualization technology were used to survey the growth and development trends of HSS research based on the Web of Science publications during the past 15 years. Results China’s international publications on HSS research increased rapidly compared to those of the global HSS and Chinese scientific studies. Growth trends indicate that collaboration among countries, institutions and authors has also increased. China’s leading partners were all developed countries, such as the US, the UK, Australia and Canada, which have contributed to the majority of the joint publications. The academic impact of publications involving partners from European and American countries was relatively higher than those involving partners from Asian countries. Prominent institutions were universities that could be primarily classified into two groups, namely, Mainland China on the one hand and Hong Kong universities and foreign universities on the other. The most prominent actors were elite institutions, such as Peking University, Fudan University, Chinese University of Hong Kong, University of Hong Kong. The papers published by the Chinese Ministry of Health had relatively high academic impact, whereas those published by Mainland China universities alone had a lower academic impact compared to foreign cooperation papers. Issues related to the Chinese healthcare reform, priority diseases (e.g., breast cancer, HIV/AIDS, tuberculosis, etc.), health systems performance, quality of life and measurement tools, aging problems and research methods have been the most popular HSS topics in China in recent years. Conclusions Despite the extensive achievement of the Chinese HSS reforms and research, gaps and challenges remain to be addressed, including those related to health insurance and the effects of the evaluation of essential medicine systems, human resources training and allocation in the health sector, government hospitals reforms and health services systems remodeling. These findings could help scholars and decision-makers understand the current status and likely future trends of the Chinese HSS research, and help them select the most appropriate collaboration partners and policies.
    Full-text · Article · Jan 2016 · Israel Journal of Health Policy Research
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    • "2 TABEA BORK-HÜFFER & FRAUKE KRAAS shortages, taking place much quicker in rural areas than in urban areas (for a detailed overview of the steps of privatisation see Lim et al. 2002). Compared with the wide range of research on the public sector, analyses of the quality and the organisation of the private sector still remain scant, though research on this topic is on the increase (examples are Blumenthal and Hsiao 2005; Eggleston et al. 2010; Tam 2010). Private for-profit hospitals and clinics have emerged as important players in China's health care market (Ma et al. 2008), but the public health care provision system and within it especially public hospitals are still dominant (only 12.2% of all visits to medical institutions in 2008 were visits to private facilities , China Health Survey 2009; MoH 2009). "
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    ABSTRACT: One of the unintended effects of China's health care reforms is the emergence of unregistered practitioners. We discuss reasons for their development and their role in the urban health care provision system under consideration of general developments in health care provision and health governance – thereby drawing scientific attention to a by far under-researched topic. We analyse the basic characteristics and strategies of clinic-based unregistered practitioners in Guangzhou and examine their perception and utilisation by rural-to-urban migrants. The research design followed a qualitative dominant mixed methods research approach, which included expert interviews with representatives of administration, indepth interviews with practitioners and migrants, a quantitative survey with 450 migrants and field observations. According to our results, gaps in the formal health care system – especially lack of access of marginalised population groups and inadequate responsiveness – poor enforcement of regulation and corrupt executive person-nel are responsible for their emergence and prevalence.
    Full-text · Article · Jul 2015 · Tijdschrift voor Economische en Sociale Geografie
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