Equity and public governance in health system reform: challenges and opportunities for China

Hana Brixi, Yan Mu, Beatrice Targa and David Hipgrave

No 5530, Policy Research Working Paper Series from The World Bank

Abstract: Achieving the objective of China's current health system reform, namely equitable improvements in health outcomes, will be difficult not least because of the continuously growing income disparities in the country. The analysis in this paper shows that since 2000, disparity in selected health outcomes has been declining across provinces, largely due to earmarked central government allocations. By contrast, public expenditure on health is increasingly regressive (positively correlated with local income per capita) across provinces, and across prefectures and lower levels within provinces. The increasing inequity in public expenditure at sub-national levels indicates that incentives, responsibilities, and resources at sub-national levels are not well aligned with China's national priorities. To address the weaknesses in equity and efficiency that characterize China's health system and health outcomes, China's health system reform may require complementary reforms to improve governance for public service delivery across sectors.

Keywords: Health Monitoring&Evaluation; Health Systems Development&Reform; Health Economics&Finance; Regional Rural Development; Economic Theory&Research (search for similar items in EconPapers)
Date: 2010-10-01
New Economics Papers: this item is included in nep-dev, nep-hea, nep-pbe and nep-tra
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
http://www-wds.worldbank.org/external/default/WDSC ... System1Reform1cn.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:wbk:wbrwps:5530

Access Statistics for this paper

More papers in Policy Research Working Paper Series from The World Bank 1818 H Street, N.W., Washington, DC 20433. Contact information at EDIRC.
Bibliographic data for series maintained by Roula I. Yazigi ().