Public Hospitals in China

2015 ◽  
Vol 4 (1) ◽  
pp. 53-72
Author(s):  
Donghai Wei ◽  
Louis Rubino
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Essential Medicine ◽  
Universal Coverage ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
The Public ◽  
Reform Plan ◽  
Health Care Leaders ◽  
Primary Health Care Facilities

China has had some initial success in its current health care reform efforts. Five areas of reform have been targeted and include providing universal coverage, equitable access to basic health insurance, establishing an essential medicine system, and improving primary health care facilities. The last area, the reform of the public hospitals, remains the most difficult to reform. General guidelines have been established by the national government and movement is being taken to delegate authority to local units for implementation. The aim of this paper is to compare China's formal government sponsored health care reform plan for public hospitals to the acknowledgement and acceptance by a sample of health care leaders in Guangzhou. Challenges are strong and include cost accountability, doctor training, employee empowerment, improprieties, and the influence of private hospitals. Based on this qualitative research, conclusions and recommendations are made by the authors as to what is necessary to have effective pubic hospital reform in China.

Public Hospitals in China

2016 ◽  
pp. 1296-1315
Author(s):  
Donghai Wei ◽  
Louis Rubino
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Essential Medicine ◽  
Universal Coverage ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Private Hospitals ◽  
The Public ◽  
Reform Plan ◽  
Health Care Leaders

China has had some initial success in its current health care reform efforts. Five areas of reform have been targeted and include providing universal coverage, equitable access to basic health insurance, establishing an essential medicine system, and improving primary health care facilities. The last area, the reform of the public hospitals, remains the most difficult to reform. General guidelines have been established by the national government and movement is being taken to delegate authority to local units for implementation. The aim of this paper is to compare China's formal government sponsored health care reform plan for public hospitals to the acknowledgement and acceptance by a sample of health care leaders in Guangzhou. Challenges are strong and include cost accountability, doctor training, employee empowerment, improprieties, and the influence of private hospitals. Based on this qualitative research, conclusions and recommendations are made by the authors as to what is necessary to have effective pubic hospital reform in China.

scholarly journals Establishing Appropriate Agency Relationships for Providers in China

2019 ◽  
Vol 56 ◽  
pp. 004695801987234
Author(s):  
Yu Liu ◽  
Richard B. Saltman
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Financial Incentives ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Multiple Roles ◽  
Chinese Patients ◽  
Chinese Government ◽  
Physician Agency

Physicians play multiple roles in a health system. They typically serve simultaneously as the agent for patients, for insurers, for their own medical practices, and for the hospital facilities where they practice. Theoretical and empirical results have demonstrated that financial relations among these different stakeholders can affect clinical outcomes as well as the efficiency and quality of care. What are the physicians’ roles as the agents of Chinese patients? The marketization approach of China’s economic reforms since 1978 has made hospitals and physicians profit-driven. Such profit-driven behavior and the financial tie between hospitals and physicians have in turn made physicians more the agents of hospitals rather than of their patients. While this commentary acknowledges physicians’ ethics and their dedication to their patients, it argues that the current physician agency relation in China has created barriers to achieving some of the central goals of current provider-side health care reform efforts. In addition to eliminating existing perverse financial incentives for both hospitals and physicians, the need for which is already agreed upon by numerous scholars, we argue that the success of the ongoing Chinese public hospital reform and of overall health care reform also relies on establishing appropriate physician-hospital agency relations. This commentary proposes 2 essential steps to establish such physician-hospital agency relations: (1) minimize financial ties between senior physicians and tertiary-level public hospitals by establishing a separate reimbursement system for senior physicians, and (2) establishing a comprehensive physician professionalism system underwritten by the Chinese government, professional physician associations, and major health care facilities as well as by physician leadership representatives. Neither of these suggestions is addressed adequately in current health care reform activities.

Health Care Reform

2013 ◽  
Author(s):  
Stephen H. Gorin ◽  
Terry Mizrahi
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
National Level ◽  
Universal Coverage ◽  
The United States ◽  
Professional Organizations ◽  
National Health Care ◽  
The Public ◽  
Policy Debates ◽  
Legislative Proposals

This entry presents an overview of national health-care reform in the United States, from its introduction into the public policy agenda at the turn of the 20th century through policy debates and legislative proposals more than a century later. Specifically, it concentrates on the programs and strategies to obtain universal coverage for health and mental-health services for all Americans at the national level, with limited success. It ends with a discussion of the Affordable Care Act (ACA). Special emphasis is laid on the roles of social workers and their professional organizations during this period.

scholarly journals A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

2015 ◽  
Vol 31 (2) ◽  
pp. 250-258 ◽  
Author(s):  
Mary-Anne Ahiabu ◽  
Britt P Tersbøl ◽  
Richard Biritwum ◽  
Ib C Bygbjerg ◽  
Pascal Magnussen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Facilities ◽  
Eastern Region ◽  
Primary Health ◽  
Retrospective Audit ◽  
Care Facilities ◽  
Primary Health Care Facilities

scholarly journals A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

2021 ◽  
Vol 18 (6) ◽  
pp. 2953
Author(s):  
Alexandro Pinto ◽  
Luciana Sepúlveda Köpcke ◽  
Renata David ◽  
Hannah Kuper
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
People With Disabilities ◽  
Health Care Facilities ◽  
Internal Space ◽  
Major Barrier ◽  
Healthcare Facilities ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws.

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