Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing

Xuanchuan Zhang, Li-Wu Chen, Keith Mueller, Qiao Yu, Jiapeng Liu and Ge Lin

Health Policy, 2011, vol. 100, issue 2-3, 181-188

Abstract: Objectives To track and evaluate the effectiveness since 2007 of urban health reform policies in Beijing that provided universal health insurance and strengthened local government-owned community health centers (CHCs).Methods Pre- and post-reform data on outpatient visits, staff, and financial statements among all CHCs in a district in Beijing were analyzed by the nonparametric Kruskal-Wallis method. Field surveys were also conducted to supplement the statistical analysis.Results The post-reform data showed a substantial increase in outpatient visits at the district level, but the number of outpatient visits was flat at the CHC level. In addition, short-term CHC responses to reform policies, such as employment growth, and operating expense-to-revenue ratio, have not been cost effective.Conclusion The overall increase in outpatient visits at the district level, including at large hospitals, conceals the fact that CHCs within the district were unable to attract a greater number of patients. The lack of operational efficiency in the process of establishing and transforming CHCs may put the primary care system at financial risk in the long run. Well-synchronized policy measures should be considered in future reforms, especially in shaping the behaviors of patients, CHCs, and physicians.

Keywords: Community; health; centers; Financial; performance; Health; care; reform; Policy; effectiveness; China (search for similar items in EconPapers)
Date: 2011
References: Add references at CitEc
Citations: View citations in EconPapers (8)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0168-8510(10)00297-6
Full text for ScienceDirect subscribers only

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:eee:hepoli:v:100:y:2011:i:2-3:p:181-188

Access Statistics for this article

Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput

More articles in Health Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu () and ().