Health Reform, Equity and Primary Healthcare

This paper provides an analysis of the national Indigenous reform strategy – known as Closing the Gap – in the context of broader health system reforms underway to assess whether current attempts at addressing Indigenous disadvantage are likely to be successful. Drawing upon economic theory and empirical evidence, the paper analyses key structural features necessary for securing system performance gains capable of reducing health disparities. Conceptual and empirical attention is given to the features of comprehensive primary healthcare, which encompasses the social determinants impacting on Indigenous health. An important structural prerequisite for securing genuine improvements in health outcomes is the unifying of all funding and policy responsibilities for comprehensive primary healthcare for Indigenous Australians within a single jurisdictional framework. This would provide the basis for implementing several key mutually reinforcing components necessary for enhancing primary healthcare system performance. The announcement to introduce a long-term health equality plan in partnership with Aboriginal people represents a promising development and may provide the window of opportunity needed for implementing structural reforms to primary healthcare. What is known about the topic? Notwithstanding the intention of previous policies, considerable health disparity exists between Indigenous and non-Indigenous Australians. Australia has now embarked on its most ambitious national Indigenous health reform strategy, but there has been little academic analysis of whether such reforms are capable of eliminating health disadvantage for Aboriginal people. What does the paper add? This paper provides a critical analysis of Indigenous health reforms to assess whether such policy initiatives are likely to be successful and outlines key structural changes to primary healthcare system arrangements that are necessary to secure genuine system performance gains and improve health outcomes for Indigenous Australians. What are the implications for practitioners? For policymakers, the need to establish genuine partnership and engagement between Aboriginal people and the Australian government in pursuing a national Indigenous reform agenda is of critical importance. The establishment of the National Congress of Australia’s First Peoples provides the opportunity for policymakers to give special status to Indigenous Australians in health policy development and create the institutional breakthrough necessary for effecting primary healthcare system change.

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The Development Trend of Primary Healthcare after Health Reform in China

10.21203/rs.3.rs-17837/v2 ◽

2020 ◽

Author(s):

Jie Feng ◽

Yanhong Gong ◽

Hui Li ◽

Jianxiong Wu ◽

Jia Zhang ◽

...

Keyword(s):

Health Service ◽

Health System ◽

Primary Healthcare ◽

Service Provision ◽

Health Reform ◽

Health Resources ◽

Resources Allocation ◽

Upward Trend ◽

Health Service Provision ◽

The Government

Abstract Background: Re-constructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on whether the role of primary healthcare in the health system is strengthened in China.Methods: The data of this study came from the China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision, and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system.Results: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (P<0.001). However, compared the indicators in 2009, excepting for the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 4.04% for practicing (assistant) physicians, by 2.55% for nurses, by 4.06% for total revenues , by 5.54% for beds, by 7.37% for outpatient visits.Conclusion: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should improve the awareness of the importance of primary healthcare at all levels of local governments and ensure adequate financial input.

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Analysis of government investment in primary healthcare institutions to promote equity during the three-year health reform program in China

BMC Health Services Research ◽

10.1186/1472-6963-13-114 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 23

Author(s):

Xiaopeng Zhang ◽

Yuqi Xiong ◽

Jing Ye ◽

Zhaohua Deng ◽

Xinping Zhang

Keyword(s):

Primary Healthcare ◽

Health Reform ◽

Government Investment ◽

Reform Program

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Does health reform achieve the goal of strengthening primary healthcare in China?

10.21203/rs.3.rs-17837/v1 ◽

2020 ◽

Author(s):

Jie Feng ◽

Yanhong Gong ◽

Hui Li ◽

Jianxiong Wu ◽

Jia Zhang ◽

...

Keyword(s):

Health Service ◽

Health System ◽

Primary Healthcare ◽

Service Provision ◽

Health Reform ◽

Health Resources ◽

Resources Allocation ◽

Upward Trend ◽

Health Service Provision ◽

The Government

Abstract Background: Re-constructing the primary healthcare system is the focus of the new round of Chinese health reform. Nevertheless, there have been few studies focusing on whether the role of primary healthcare in the health system is strengthened in China.Methods: The data of this study came from the China Health Statistical Yearbook (2009–2018). We evaluated the development of primary healthcare based on the absolute values of health resources allocation and health service provision, and evaluated the status of primary healthcare throughout the health system based on the composition ratios of the indicators across the health system.Results: From 2009 to 2018, the amounts of health resources allocation and health service provision of Chinese primary healthcare institutions showed a significant upward trend (P<0.001). However, compared the indicators in 2009, excepting for the proportion of grants from the government in the whole health system has an upward trend, the proportions of other indicators had an escalating trend in 2018 by 4.04% for practicing (assistant) physicians, by 2.55% for nurses, by 4.06% for total revenues , by 5.54% for beds, by 7.37% for outpatient visits.Conclusion: The primary healthcare system has developed rapidly, but its development speed lagged behind the entire health system, resulting in the weakening of its actual functions, which is not in line with the goal of health reform. The government should improve the awareness of the importance of primary healthcare at all levels of local governments and ensure adequate financial input.

Download Full-text