Universal health insurance coverage for 1.3 billion people: What accounts for China's success?
Identifieur interne : 002B06 ( Ncbi/Curation ); précédent : 002B05; suivant : 002B07Universal health insurance coverage for 1.3 billion people: What accounts for China's success?
Auteurs : Hao Yu [États-Unis]Source :
- Health policy (Amsterdam, Netherlands) [ 1872-6054 ] ; 2015.
Descripteurs français
- KwdFr :
- Assurance maladie (), Assurance maladie (organisation et administration), Chine, Financement du gouvernement (), Financement du gouvernement (organisation et administration), Flambées de maladies, Humains, Maîtrise des coûts (organisation et administration), Politique, Remboursement incitatif (organisation et administration), Réforme des soins de santé (organisation et administration), Syndrome respiratoire aigu sévère (épidémiologie), Virus du SRAS, Évaluation de programme.
- MESH :
- organisation et administration : Assurance maladie, Financement du gouvernement, Maîtrise des coûts, Remboursement incitatif, Réforme des soins de santé.
- épidémiologie : Syndrome respiratoire aigu sévère.
- Assurance maladie, Chine, Financement du gouvernement, Flambées de maladies, Humains, Politique, Virus du SRAS, Évaluation de programme.
English descriptors
- KwdEn :
- China, Cost Control (organization & administration), Disease Outbreaks, Financing, Government (organization & administration), Financing, Government (statistics & numerical data), Health Care Reform (organization & administration), Humans, Insurance, Health (organization & administration), Insurance, Health (statistics & numerical data), Politics, Program Evaluation, Reimbursement, Incentive (organization & administration), SARS Virus, Severe Acute Respiratory Syndrome (epidemiology), Universal Health Insurance (organization & administration), Universal Health Insurance (statistics & numerical data).
- MESH :
- epidemiology : Severe Acute Respiratory Syndrome.
- organization & administration : Cost Control, Financing, Government, Health Care Reform, Insurance, Health, Reimbursement, Incentive, Universal Health Insurance.
- statistics & numerical data : Financing, Government, Insurance, Health, Universal Health Insurance.
- China, Disease Outbreaks, Humans, Politics, Program Evaluation, SARS Virus.
Abstract
China successfully achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history. While the achievement is widely recognized, it is still largely unexplored why China was able to attain it within a short period. This study aims to fill the gap. Through a systematic political and socio-economic analysis, it identifies seven major drivers for China's success, including (1) the SARS outbreak as a wake-up call, (2) strong public support for government intervention in health care, (3) renewed political commitment from top leaders, (4) heavy government subsidies, (5) fiscal capacity backed by China's economic power, (6) financial and political responsibilities delegated to local governments and (7) programmatic implementation strategy. Three of the factors seem to be unique to China (i.e., the SARS outbreak, the delegation, and the programmatic strategy.) while the other factors are commonly found in other countries' insurance expansion experiences. This study also discusses challenges and recommendations for China's health financing, such as reducing financial risk as an immediate task, equalizing benefit across insurance programs as a long-term goal, improving quality by tying provider payment to performance, and controlling costs through coordinated reform initiatives. Finally, it draws lessons for other developing countries.
DOI: 10.1016/j.healthpol.2015.07.008
PubMed: 26251322
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<term>Évaluation de programme</term>
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<front><div type="abstract" xml:lang="en">China successfully achieved universal health insurance coverage in 2011, representing the largest expansion of insurance coverage in human history. While the achievement is widely recognized, it is still largely unexplored why China was able to attain it within a short period. This study aims to fill the gap. Through a systematic political and socio-economic analysis, it identifies seven major drivers for China's success, including (1) the SARS outbreak as a wake-up call, (2) strong public support for government intervention in health care, (3) renewed political commitment from top leaders, (4) heavy government subsidies, (5) fiscal capacity backed by China's economic power, (6) financial and political responsibilities delegated to local governments and (7) programmatic implementation strategy. Three of the factors seem to be unique to China (i.e., the SARS outbreak, the delegation, and the programmatic strategy.) while the other factors are commonly found in other countries' insurance expansion experiences. This study also discusses challenges and recommendations for China's health financing, such as reducing financial risk as an immediate task, equalizing benefit across insurance programs as a long-term goal, improving quality by tying provider payment to performance, and controlling costs through coordinated reform initiatives. Finally, it draws lessons for other developing countries. </div>
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